Individual
RANDALL RAY SAMBERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1121 HIGHWAY 35 N, ROCKPORT, TX 78382-3112
(361) 524-2004
(361) 400-5312
Mailing address
PO BOX 1299, ARANSAS PASS, TX 78335-1299
(361) 524-2004
(361) 400-5312
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
E6598
TX
2086S0129X
Vascular Surgery Physician
E6598
TX
208C00000X
Colon & Rectal Surgery Physician
E6598
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00RB70
MEDICARE PTAN
TX
05
—
0356867-01
—
TX
Enumeration date
08/15/2006
Last updated
08/04/2015
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