Individual
RANDALL PARKER KIRBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., F.A.C.S.
Contact information
Practice address
8140 WALNUT HILL LN STE 800, DALLAS, TX 75231-4396
(214) 253-0170
(214) 253-0171
Mailing address
PO BOX 650759, DALLAS, TX 75265-0759
(214) 253-0170
(214) 253-0171
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
H5716
TX
2086S0129X
Vascular Surgery Physician
H5716
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0015JL
BCBS PROVIDER NUMBER
TX
05
—
132099607
—
TX
01
—
H5716
TX STATE LICENSE NUMBER
TX
Enumeration date
05/05/2006
Last updated
02/03/2026
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