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RANDI HERBOLARIO BACULI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1151 N BUCKNER BLVD BLDG 1, DALLAS, TX 75218-3426
(972) 423-0977
(972) 578-1867
Mailing address
2504 FIGTREE LN, PLANO, TX 75074-4858
(972) 423-0977
(972) 578-1867

Taxonomy

Speciality
Code
Description
License number
State
2084N0008X
Neuromuscular Medicine (Psychiatry & Neurology) Physician
102027
WI
2084N0400X
Neurology Physician
01051720A
IN
2084N0400X
Neurology Physician
CI0006180
DE
2084N0400X
Neurology Physician
Primary
L2117
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
149294403
TX
05
149294404
TX
01
7477332
AETNA
01
8AJ227
BCBS
TX
Enumeration date
05/01/2006
Last updated
11/21/2025
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