Individual
MR. MICHAEL GENE RANDALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
207 S OLD BETSY RD, KEENE, TX 76059-2426
(817) 645-8888
(817) 645-4984
Mailing address
625 BROAD VALLEY DR, BURLESON, TX 76028-6511
(817) 905-3267
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
2040160
TX
Other
Enumeration date
05/02/2019
Last updated
05/02/2019
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