Individual
DR. MARK ALFORD RANDEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3618 N UNIVERSITY DR, NACOGDOCHES, TX 75965-2539
(936) 568-9993
(936) 568-9996
Mailing address
PO BOX 630668, NACOGDOCHES, TX 75963-0668
(936) 568-9993
(936) 568-9996
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
16951
OK
208600000X
Surgery Physician
H6529
TX
2086S0129X
Vascular Surgery Physician
16951
OK
2086S0129X
Vascular Surgery Physician
Primary
H6529
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00323J
BLUE CROSS BLUE SHIELD
TX
05
—
030062602
—
TX
05
—
030062603
—
TX
05
—
030062604
—
TX
01
—
8CN590
BLUE CROSS BLUE SHIELD
TX
Enumeration date
02/22/2007
Last updated
11/03/2025
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