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Organization
RANDALL L SIMONSEN MD PA
Active
Organization
RANDALL L SIMONSEN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDALL L SIMONSEN MD (PRESIDENT)
(361) 779-8813
Entity
Organization
Contact information
Practice address
1311 EAST GENERAL CAVAZOS, CHRISTUS SPOHN HOSPITAL KLEBERG, KINGSVILLE, TX 78363
(361) 595-7979
Mailing address
15210 CARTAGENA CT, CORPUS CHRISTI, TX 78418-6914
(361) 779-8813
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
H8840
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1235261082
NPI (TYPE 1)
TX
05
—
123989901
—
TX
Enumeration date
12/04/2012
Last updated
12/04/2012
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