Individual
DR. JOHN RANDALL MCINTIRE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
700 MEDICAL PKWY, BRENHAM, TX 77833-5413
(979) 337-5000
(979) 830-2244
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
E8707
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100656103
—
TX
01
—
102776
SUPERIOR CHIPS
TX
01
—
70343
AMERIGROUP
TX
Enumeration date
05/23/2005
Last updated
01/27/2022
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