Provider Demographics
NPI:1427030139
Name:RANELLE, ANN (DO)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:
Last Name:RANELLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:5000 COLLINWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76107-3606
Mailing Address - Country:US
Mailing Address - Phone:817-732-5593
Mailing Address - Fax:817-342-0388
Practice Address - Street 1:5000 COLLINWOOD AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76107-3606
Practice Address - Country:US
Practice Address - Phone:817-732-5593
Practice Address - Fax:817-342-0388
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM2035207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7981779OtherAETNA
TX7314728OtherCIGNA
TX1417007527OtherBCBS GROUP
TXM2035OtherSTATE MEDICAL LICENSE
TX1427030139OtherBCBS
TX7314728OtherCIGNA
TX1427030139OtherBCBS