Individual
RYAN TIMOTHY RANDLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
231 S COLLINS RD, SUNNYVALE, TX 75182-4624
(972) 203-6240
Mailing address
DEPT 96-0390, OKLAHOMA CITY, OK 73196-0390
(877) 485-4474
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
N4025
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205875203
—
TX
01
—
BP1-0026732
INSTITUTIONAL PERMIT
—
Enumeration date
05/31/2007
Last updated
03/16/2010
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