Provider Demographics
NPI:1780797282
Name:RANSOM, JOHN JACOB (DPM)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:JACOB
Last Name:RANSOM
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1524 N WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-6074
Mailing Address - Country:US
Mailing Address - Phone:830-832-6715
Mailing Address - Fax:
Practice Address - Street 1:1524 N WALNUT AVE
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-6074
Practice Address - Country:US
Practice Address - Phone:830-625-1642
Practice Address - Fax:830-625-1672
Is Sole Proprietor?:No
Enumeration Date:2006-08-17
Last Update Date:2007-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1634213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7568545OtherAETNA
TX8M5953OtherBLUE CROSS BLUE SHIELD
TXP00078891OtherMEDICARE RAILROAD
TX7568545OtherAETNA
TX8M5953OtherBLUE CROSS BLUE SHIELD