MEDICARE: DR. DAVID RUSSELL RANSCHAERT JR. PSY.D.

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	103TC0700X	Clinical Psychologist	37475	TX

General Provider Information

NPI Number	:	1770817801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID RUSSELL RANSCHAERT JR. PSY.D.

Provider Business Mailing Address
First Line	:	7300 BROMPTON ST APT 4518
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-2163
Country	:	US
Telephone Number	:	972-559-4802
Fax Number	:

Provider Business Practice Location Address
First Line	:	7300 BROMPTON ST APT 4518
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-2163
Country	:	US
Telephone Number	:	502-797-0395
Fax Number	:

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

Provider Enumeration Date	:	09/22/2009
Last Update Date	:	12/05/2024

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