Organization
RANDALL P. MAYDEW, M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDALL PAUL MAYDEW M.D. (SOLE PROPRIETOR)
(469) 964-0807
Entity
Organization
Contact information
Practice address
7777 FOREST LN, SUITE B238, DALLAS, TX 75230-2505
(972) 566-5813
Mailing address
3400 WELBORN ST APT 420, DALLAS, TX 75219-5215
(469) 964-0807
(214) 363-7036
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
J0589
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0529554-02
—
TX
01
—
1255350757
PERSONAL NPI NUMBER
—
05
—
263088
—
AZ
05
—
33605
—
NM
05
—
91842187
—
CO
05
—
P8B057101
—
TX
Enumeration date
05/06/2007
Last updated
05/18/2008
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