Individual
RANDAL W WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4411 MEDICAL DR, STE 300, SAN ANTONIO, TX 78229-3822
(210) 614-5400
(210) 614-2413
Mailing address
4411 MEDICAL DR STE 300, SAN ANTONIO, TX 78229-3824
(210) 614-5400
(210) 614-2413
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
F4677
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133943410
—
TX
01
—
8CM527
BCBS TX
—
01
—
P00898304
RAILROAD MEDICARE
TX
01
—
TXB112502
MEDICARE
TX
Enumeration date
12/30/2005
Last updated
01/18/2022
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