MEDICARE: DEANDRA RANSOM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA08591	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679906168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEANDRA RANSOM

Provider Business Mailing Address
First Line	:	3320 OAKWELL CT
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78218-3128
Country	:	US
Telephone Number	:	210-829-5180
Fax Number	:	210-829-5030

Provider Business Practice Location Address
First Line	:	8019 S NEW BRAUNFELS STE 120
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78235-1069
Country	:	US
Telephone Number	:	210-829-5180
Fax Number	:	210-829-5030

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2013
Last Update Date	:	03/05/2026

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Directions to “ DEANDRA RANSOM ” Practice Location

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