Individual
USHA RENGANATHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1791 HIGHWAY 64 E, ANAMOSA, IA 52205-2112
(319) 462-6043
(319) 462-6043
Mailing address
20079 STONE OAK PKWY STE 1105485, SAN ANTONIO, TX 78258-6942
(210) 201-4590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
38862
IA
207Q00000X
Family Medicine Physician
R-8188
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1700084191
—
IA
Enumeration date
07/06/2007
Last updated
12/12/2020
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