Provider Demographics
NPI:1265697015
Name:RANA, SHITAL MANOHAR (MD)
Entity type:Individual
Prefix:DR
First Name:SHITAL
Middle Name:MANOHAR
Last Name:RANA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:4140 HERITAGE TRACE PKWY.
Mailing Address - Street 2:SUITE 312
Mailing Address - City:KELLER
Mailing Address - State:TX
Mailing Address - Zip Code:76244-5311
Mailing Address - Country:US
Mailing Address - Phone:817-714-7353
Mailing Address - Fax:817-741-7501
Practice Address - Street 1:4140 HERITAGE TRACE PKWY
Practice Address - Street 2:SUITE 312
Practice Address - City:KELLER
Practice Address - State:TX
Practice Address - Zip Code:76244-5311
Practice Address - Country:US
Practice Address - Phone:817-741-7353
Practice Address - Fax:817-741-7501
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN6598207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine