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Individual
RANDOLPH J. POTTS
Active
Individual
RANDOLPH J. POTTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
253726
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
84432U
BLUE SHIELD
TX
01
—
P00281070
RR/MEDICARE
TX
Enumeration date
04/06/2006
Last updated
07/10/2007
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