Individual
MANJIT RANDHAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1980 EAST MULBERRY ST, ANGLETON, TX 77515
(979) 848-3068
(979) 849-1423
Mailing address
1980 E MULBERRY ST, ANGLETON, TX 77515-3948
(979) 848-3068
(979) 849-1423
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
J4464
TX
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
J4464
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050062192
UNSPECIFIED RAILROAD MEDICARE
TX
05
—
137351612
—
TX
05
—
137351613
—
TX
05
—
137351614
—
TX
01
—
P00200151
RAILROAD MEDICARE
—
01
—
P00954847
MEDICARE RAILROAD FACO
TX
Enumeration date
06/25/2006
Last updated
01/07/2021
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