Provider Demographics
NPI:1932126422
Name:CHERIAN, RANY ANTONY (MD)
Entity Type:Individual
Prefix:
First Name:RANY
Middle Name:ANTONY
Last Name:CHERIAN
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 1:1703 E. 29TH STREET
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77802
Mailing Address - Country:US
Mailing Address - Phone:979-779-4756
Mailing Address - Fax:979-823-3018
Practice Address - Street 1:1703 E. 29TH STREET
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802
Practice Address - Country:US
Practice Address - Phone:979-779-4756
Practice Address - Fax:979-823-3018
Is Sole Proprietor?:No
Enumeration Date:2006-07-17
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6918207Q00000X, 207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX133193606Medicaid
TX091802101Medicaid
TX0027BMMedicare PIN
TXC14425Medicare UPIN
TX091802101Medicaid