Organization
A RANDALL MOODY II MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUSTIN RANDALL MOODY II MD (MD)
(830) 285-4096
Entity
Organization
Contact information
Practice address
5788 ECKHERT RD, FRANK M. TEJEDA VA OUTPATIENT CLINIC, C&P DEPARTMENT, SAN ANTONIO, TX 78240-3900
(830) 285-4096
(830) 896-3310
Mailing address
5788 ECKHERT RD, FRANK M. TEJEDA VA OUTPATIENT CLINIC, C& P DEPARTMENT, SAN ANTONIO, TX 78240-3900
(830) 285-4096
(830) 896-3310
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
178696401
—
TX
Enumeration date
07/02/2006
Last updated
07/28/2013
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