Provider Demographics
NPI:1093974503
Name:RANEY, KENNETH CARTER (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:CARTER
Last Name:RANEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 N BECKLEY AVENUE
Mailing Address - Street 2:DEPT OF MEDICAL EDUCATION
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203
Mailing Address - Country:US
Mailing Address - Phone:214-947-2300
Mailing Address - Fax:
Practice Address - Street 1:1441 N BECKLEY AVENUE
Practice Address - Street 2:DEPT OF MEDICAL EDUCATION
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203
Practice Address - Country:US
Practice Address - Phone:214-947-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-09
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6320208M00000X
TXN9118207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist