Individual
RANDALL L SIMONSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PA
Contact information
Practice address
1311 GENERAL CAVAZOS BLVD, KINGSVILLE, TX 78363-7129
(361) 595-1661
Mailing address
15210 CARTAGENA CT, CORPUS CHRISTI, TX 78418-6914
(361) 779-8813
(361) 595-9895
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
H8840
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00U07W
—
TX
Enumeration date
03/09/2007
Last updated
10/18/2012
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