Provider Demographics
NPI:1083737217
Name:RANBHISE, PRIYADARSHINI S (MD)
Entity Type:Individual
Prefix:
First Name:PRIYADARSHINI
Middle Name:S
Last Name:RANBHISE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5132 CATHEDRAL LN
Mailing Address - Street 2:IN COMPASS HEALTH
Mailing Address - City:WICHITA FALLS
Mailing Address - State:TX
Mailing Address - Zip Code:76310-1490
Mailing Address - Country:US
Mailing Address - Phone:248-275-8243
Mailing Address - Fax:
Practice Address - Street 1:1600 11TH ST
Practice Address - Street 2:IN COMPASS HEALTH
Practice Address - City:WICHITA FALLS
Practice Address - State:TX
Practice Address - Zip Code:76301-4300
Practice Address - Country:US
Practice Address - Phone:248-275-8243
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2021-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301083604207R00000X
TXQ0545207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine