Provider Demographics
NPI:1043642929
Name:NASSAR, RANA (DMD)
Entity Type:Individual
Prefix:
First Name:RANA
Middle Name:
Last Name:NASSAR
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:345 W FM 544 STE 100B
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:TX
Mailing Address - Zip Code:75094-4408
Mailing Address - Country:US
Mailing Address - Phone:694-690-1699
Mailing Address - Fax:469-969-0053
Practice Address - Street 1:619 W FM 544 STE 1B
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:TX
Practice Address - Zip Code:75094-4587
Practice Address - Country:US
Practice Address - Phone:469-969-0169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-02
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32520122300000X, 1223G0001X
SDD1025122300000X
NE7109122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist