Provider Demographics
NPI:1003158577
Name:MENDELSBERG, RANAN AYAL (MD)
Entity Type:Individual
Prefix:DR
First Name:RANAN
Middle Name:AYAL
Last Name:MENDELSBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:601 CLARA BARTON BLVD STE 350
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-5747
Mailing Address - Country:US
Mailing Address - Phone:972-426-9900
Mailing Address - Fax:972-426-9899
Practice Address - Street 1:601 CLARA BARTON BLVD STE 350
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-5747
Practice Address - Country:US
Practice Address - Phone:972-426-9900
Practice Address - Fax:972-426-9899
Is Sole Proprietor?:No
Enumeration Date:2013-03-22
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA124932208600000X
TXS11852086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX400328701Medicaid