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NPI Code Detail

MEDICARE: RANDALL WEBSTER

MEDICARE: RANDALL WEBSTER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family Therapist205151TX

General Provider Information

NPI Number : 1053172700
Entity Type Code : Individual
Provider Name (Legal Business Name) : RANDALL WEBSTER
Provider Business Mailing Address
First Line : 1604 WINDY PARK CT
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-7065
Country : US
Telephone Number : 903-445-3066
Fax Number :
Provider Business Practice Location Address
First Line : 9501 N CAPITAL OF TEXAS HWY STE 201
Second Line :
City : AUSTIN
State : TX
Zip : 78759-7250
Country : US
Telephone Number : 512-578-8070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/19/2024
Last Update Date : 01/19/2024

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Directions to “ RANDALL WEBSTER ” Practice Location

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