Provider Demographics
NPI:1235165788
Name:DAS, RANI (MD)
Entity Type:Individual
Prefix:
First Name:RANI
Middle Name:
Last Name:DAS
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 1:4407 BEE CAVES RD
Mailing Address - Street 2:BLDG 3, SUITE 301
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6405
Mailing Address - Country:US
Mailing Address - Phone:512-458-2600
Mailing Address - Fax:512-454-2292
Practice Address - Street 1:4407 BEE CAVES RD
Practice Address - Street 2:BLDG 3, SUITE 301
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6405
Practice Address - Country:US
Practice Address - Phone:512-458-2600
Practice Address - Fax:512-454-2292
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315015660207R00000X
TXN2050207R00000X, 2084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX202808604Medicaid
MI4577422Medicaid
TX202808602Medicaid
TX202808603Medicaid
TXTXB154563Medicare PIN
TX202808602Medicaid
TXTXB154566Medicare PIN
H98906Medicare UPIN
Z16001023Medicare ID - Type Unspecified