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Organization
NITI RANDHAWA,M.D., PA
Active
Organization
NITI RANDHAWA,M.D., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NINETY NINE CREDENTIALING SERVICES (CREDENTIALING)
(972) 792-5700
Entity
Organization
Contact information
Practice address
12200 PARK CENTRAL DR STE 189, DALLAS, TX 75251-2116
(469) 584-8480
(469) 587-8484
Mailing address
9101 LBJ FREEWAY, STE 710, DALLAS, TX 75243-1912
(972) 792-5700
(214) 506-1170
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
K2988
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
193400000X
TAXONOMY
TX
01
—
K2988
TX LICENSE
TX
Enumeration date
09/25/2008
Last updated
07/21/2022
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