Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | G6918 | TX |
Y | 207QA0401X | Family Doctor - Addiction Medicine | G6918 | TX |
NPI | 1932126422 |
---|---|
Provider Name | Rany Antony Cherian |
First Address | Bryan, TX 77802 |
Second Address | Bryan, TX 77802 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/07/2006 |
Last Update Date | 07/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
091802101 | (05) | TX |
133193606 | (05) | TX |
C14425 | (02) | TX |