Individual
DR. RANDY OWEN MAUFFRAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
800 MCCULLOUGH AVE, SAN ANTONIO, TX 78215-1625
(210) 226-6169
(210) 226-8365
Mailing address
800 MCCULLOUGH AVENUE, SAN ANTONIO, TX 78215
(210) 226-6169
(210) 226-8365
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
Q6232
TX
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
Q6232
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
369304601
—
TX
Enumeration date
05/12/2006
Last updated
07/21/2022
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