Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 46143 | AZ |
N | 208000000X | Pediatrician | TL31684 | SC |
Y | 2080P0207X | Pediatric Hematology-Oncologist | Q5354 | TX |
NPI | 1164658217 |
---|---|
Provider Name | Ranjan Bista |
First Address | El Paso, TX 79905-2705 |
Second Address | El Paso, TX 79905-2705 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2009 |
Last Update Date | 14/08/2015 |