Provider Demographics
NPI:1083649875
Name:RANELLE, JOHN BARRY (DO)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:BARRY
Last Name:RANELLE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 E BOWIE AVE
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8802
Mailing Address - Country:US
Mailing Address - Phone:956-536-7794
Mailing Address - Fax:956-686-2708
Practice Address - Street 1:1214 E BOWIE AVE
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8802
Practice Address - Country:US
Practice Address - Phone:956-536-7794
Practice Address - Fax:956-686-2708
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE9349207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1271355Medicaid
TX1271355Medicaid