Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | M0192 | TX |
NPI | 1053574913 |
---|---|
Provider Name | Rani Nanda |
First Address | Houston, TX 77030-1521 |
Second Address | Houston, TX 77030-1521 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2008 |
Last Update Date | 12/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1053574913 | BLUE CROSS BLUE SHIELD (01) | TX |
285821901 | (05) | TX |
BN8997403 | DEA (01) | TX |
JO137404 | DPS (01) | TX |
M0192 | MEDICAL TEXAS LICENSE (01) | TX |