MEDICARE: HARNEET KAUR RANAUTA MBBS

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	207Q00000X	Family Medicine Physician	BP1007851	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	BP1007851	OTHER	TX	TEXAS MEDICAL BOARD PIT

General Provider Information

NPI Number	:	1962149963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HARNEET KAUR RANAUTA MBBS

Provider Business Mailing Address
First Line	:	601 E SAN ANTONIO ST STE 102W
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77901-6051
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	601 E SAN ANTONIO ST STE 102W
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77901-6051
Country	:	US
Telephone Number	:	361-582-0185
Fax Number	:

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

Provider Enumeration Date	:	05/19/2022
Last Update Date	:	05/26/2022

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