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Individual

RANDOLPH ALVIN NELSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1401 ST JOSEPH PKWY, HOUSTON, TX 77002-8301
(713) 757-7557
(713) 756-5922
Mailing address
2606 IRIS CT, PEARLAND, TX 77584-9400
(281) 412-9026
(281) 412-4195

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
L1949
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1462699-02
TX
01
1508846742
BCBSTX
TX
01
8G1501
BC/BS PROVIDER NUMBER
TX
01
930117290
RAILROAD MEDICARE PROV #
TX
Enumeration date
01/21/2006
Last updated
09/21/2010
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