Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A124932 | CA |
N | 208600000X | Surgeon | A124932 | CA |
Y | 2086S0129X | Vascular Surgeon | S1185 | TX |
NPI | 1003158577 |
---|---|
Provider Name | Dr. Ranan Ayal Mendelsberg |
First Address | Garland, TX 75042-5747 |
Second Address | Garland, TX 75042-5747 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/03/2013 |
Last Update Date | 01/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
400328701 | (05) | TX |