Individual
RANDY CRAIG RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1783 TROUP HIGHWAY, TYLER, TX 75701
(903) 595-2283
(903) 595-1063
Mailing address
PO BOX 702620, TULSA, OK 74170-2620
(888) 608-7999
(512) 331-1605
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
F9993
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
128175006
—
TX
01
—
P00044309
MEDICARE RR
—
Enumeration date
07/05/2006
Last updated
01/07/2013
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