Provider Demographics
NPI:1245335694
Name:RONALD F KAHN MD PA
Entity type:Organization
Organization Name:RONALD F KAHN MD PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:F
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:979-268-0786
Mailing Address - Street 1:1920 W VILLA MARIA RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77807-4857
Mailing Address - Country:US
Mailing Address - Phone:979-268-0786
Mailing Address - Fax:979-846-2136
Practice Address - Street 1:1920 W VILLA MARIA RD
Practice Address - Street 2:SUITE 201
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77807-4857
Practice Address - Country:US
Practice Address - Phone:979-268-0786
Practice Address - Fax:979-846-2136
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-13
Last Update Date:2014-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL5000207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00536ZMedicare PIN
TX00583YMedicare PIN