Individual
RANDALL MATTHEW MCCOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, RN, CNS-AG
Contact information
Practice address
1400 8TH AVE, FORT WORTH, TX 76104-4110
(817) 926-2544
Mailing address
PO BOX 1291, WEATHERFORD, TX 76086-1291
(325) 451-0600
Taxonomy
Speciality
Code
Description
License number
State
364S00000X
Clinical Nurse Specialist
Primary
AP136405
TX
Other
Enumeration date
04/18/2018
Last updated
04/18/2018
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