MEDICARE: TONYA SUE RANS-NIGRO MD

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	208000000X	Pediatrics Physician	024384	LA

General Provider Information

NPI Number	:	1891781134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TONYA SUE RANS-NIGRO MD

Provider Business Mailing Address
First Line	:	12103 WELLSTONE RUN
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78249-3915
Country	:	US
Telephone Number	:	210-265-5671
Fax Number	:

Provider Business Practice Location Address
First Line	:	759 MDOS/MMIA
Second Line	:	LACKLAND AFB
City	:	SAN ANTONIO
State	:	TX
Zip	:	78236
Country	:	US
Telephone Number	:	210-292-2117
Fax Number	:

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

Provider Enumeration Date	:	09/22/2005
Last Update Date	:	07/08/2007

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