Provider Demographics
NPI:1902096019
Name:RANADE, ANJALI (MD)
Entity type:Individual
Prefix:
First Name:ANJALI
Middle Name:
Last Name:RANADE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2808
Mailing Address - Country:US
Mailing Address - Phone:936-523-1720
Mailing Address - Fax:936-523-1723
Practice Address - Street 1:508 MEDICAL CENTER BLVD
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2808
Practice Address - Country:US
Practice Address - Phone:936-523-1720
Practice Address - Fax:936-523-1723
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2010-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN1094208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00812722OtherRAILROAD MEDICARE
TX00J21AOtherGROUP MEDICARE NUMBER
TX8L26351Medicare PIN
TXP00812722OtherRAILROAD MEDICARE