Provider Demographics
NPI:1053574913
Name:NANDA, RANI (DO)
Entity type:Individual
Prefix:
First Name:RANI
Middle Name:
Last Name:NANDA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17500 W GRAND PKWY S
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2562
Mailing Address - Country:US
Mailing Address - Phone:281-725-5026
Mailing Address - Fax:
Practice Address - Street 1:17500 W GRAND PKWY S
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2562
Practice Address - Country:US
Practice Address - Phone:281-725-5026
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0192207R00000X, 207RC0200X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXM0192OtherMEDICAL TEXAS LICENSE
TX1053574913OtherBLUE CROSS BLUE SHIELD
TXJO137404OtherDPS
TX285821901Medicaid
TXBN8997403OtherDEA
TXTXB137939Medicare PIN