Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0210X | Pediatric Nephrologist | 43189 | TX |
N | 2080P0210X | Pediatric Nephrologist | A99645 | CA |
NPI | 1457477101 |
---|---|
Provider Name | Dr. Daniel Ranch |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78229-3901 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2007 |
Last Update Date | 07/12/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
215601001 | (05) | TX |
A99645 | OTHER (01) | CA |
ASO2532199009 | DEA CERTIFICATE (01) | NV |
LL1495 | MEDICAL LICENSE (01) | NV |