Individual
RANDY PAT RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU.D
Contact information
Practice address
1005 E GRAND AVE, MARSHALL, TX 75670-3558
(903) 927-1111
(903) 927-0086
Mailing address
1005 E GRAND AVE, MARSHALL, TX 75670-3558
(903) 927-1111
(432) 335-0906
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
50379
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80200A
BC/BS PROVIDER #
TX
Enumeration date
10/26/2006
Last updated
03/06/2024
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