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Individual
DR. RANDY ANTHONY FUENTES
Active
Individual
DR. RANDY ANTHONY FUENTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
F6638
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114342205
—
TX
Enumeration date
08/12/2006
Last updated
11/20/2013
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