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Organization
TEXAS AVENUE MEDICAL CLINIC
Active
Organization
TEXAS AVENUE MEDICAL CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANY A CHERIAN M.D. (BUSINESS OWNER)
(979) 779-4756
Entity
Organization
Contact information
Practice address
1703 E 29TH STREET, BRYAN, TX 77802
(979) 779-4756
(979) 823-3018
Mailing address
1703 E 29TH ST, BRYAN, TX 77802-1406
(979) 779-4756
(979) 823-3018
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207QA0401X
Addiction Medicine (Family Medicine) Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
091802101
—
TX
Enumeration date
11/16/2006
Last updated
08/21/2017
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