Provider Demographics
NPI:1407813462
Name:WARANCH, DINAH (CNM)
Entity Type:Individual
Prefix:MRS
First Name:DINAH
Middle Name:
Last Name:WARANCH
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 S COTTONWOOD
Mailing Address - Street 2:SUITE A
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5752
Mailing Address - Country:US
Mailing Address - Phone:214-366-3579
Mailing Address - Fax:214-366-3580
Practice Address - Street 1:304 S COTTONWOOD
Practice Address - Street 2:SUITE A
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5752
Practice Address - Country:US
Practice Address - Phone:214-366-3579
Practice Address - Fax:214-366-3580
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-26
Last Update Date:2012-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
176B00000X
TX564651176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX86N885OtherBLUE CROSS BLUE SHIELD
TX80122MOtherMEDICARE ID
TX088338101Medicaid
TX80122MOtherMEDICARE ID