1730490400 NPI number — JENNIFER SONG RANARIO MD, MBA.

Table of content: JENNIFER SONG RANARIO MD, MBA. (NPI 1730490400)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730490400 NPI number — JENNIFER SONG RANARIO MD, MBA.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RANARIO
Provider First Name:
JENNIFER
Provider Middle Name:
SONG
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD, MBA.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SONG
Provider Other First Name:
JENNIFER
Provider Other Middle Name:
CHU
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD, MBA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1730490400
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7200 CAMBRIDGE ST FL 10
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77030-4202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-798-1750
Provider Business Mailing Address Fax Number:
713-798-4693

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2002 HOLCOMBE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77030-4211
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-791-1414
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/28/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207N00000X , with the licence number:  Q3426 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ND0101X , with the licence number: Q3426 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)