Individual
CHARLES W RANDALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8550 DATAPOINT DR, SUITE 200, SAN ANTONIO, TX 78229-3270
(210) 615-8308
(210) 615-8313
Mailing address
8550 DATAPOINT DR, SUITE 200, SAN ANTONIO, TX 78229-3270
(210) 615-8308
(210) 615-8313
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
F53763
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
044080201
—
TX
Enumeration date
11/03/2006
Last updated
10/29/2015
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