=====================================================
General NPI Number Information
=====================================================
NPI Number | 1982986071
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | RONALD D. RANCE, M.D P.A
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/14/2011
-----------------------------------------------------
Last Update Date | 09/28/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 427 W 20TH ST SUITE 503
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77008-2441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-802-9999
-----------------------------------------------------
Fax | 713-863-9684
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 427 W 20TH ST SUITE 503
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77008-2441
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-802-9999
-----------------------------------------------------
Fax | 713-863-9684
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | MA
-----------------------------------------------------
Name | MS. BELICIA CANTERO
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 713-802-9999
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | G2462
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------