Individual
AMANDA RANDLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3201 S LOOP 256, PALESTINE, TX 75801-6901
(903) 723-0330
Mailing address
3201 S LOOP 256, PALESTINE, TX 75801-6901
(903) 723-0330
(903) 723-3259
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA14543
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
425949101
—
TX
Enumeration date
11/24/2015
Last updated
12/13/2024
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