Organization
MANJIT S RANDHAWA DO PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RITA RANDHAWA (OFFICE MANAGER)
(979) 848-3068
Entity
Organization
Contact information
Practice address
1980 EAST MULBERRY ST, ANGLETON, TX 77515
(979) 848-3068
(979) 849-1423
Mailing address
1980 EAST MULBERRY ST, ANGLETON, TX 77515
(979) 848-3068
(979) 849-1423
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
J4464
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0045PZ
BLUE SHIELD OF TEXAS
TX
05
—
168789901
—
TX
01
—
DC9500
RAILROAD MEDICARE
—
Enumeration date
06/24/2006
Last updated
01/07/2021
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