Organization
CRUCIBLE PHYSICAL MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY NAIDOO MD (OWNER)
(214) 446-5301
Entity
Organization
Contact information
Practice address
6988 LEBANON RD, FRISCO, TX 75034-6735
(214) 446-5300
(214) 446-5304
Mailing address
6988 LEBANON RD, SUITE 101, FRISCO, TX 75034-6735
(214) 446-5300
(214) 446-5304
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
40161841
TX
Other
Enumeration date
08/21/2014
Last updated
01/06/2015
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