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NPI Code Detail

MEDICARE: MR. RANDALL MEDCALF L.M.T.

MEDICARE:  MR. RANDALL  MEDCALF  L.M.T.
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
1225700000XMassage Therapist109817TX

General Provider Information

NPI Number : 1184956781
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RANDALL MEDCALF L.M.T.
Provider Business Mailing Address
First Line : PO BOX 11431
Second Line :
City : SPRING
State : TX
Zip : 77391-1431
Country : US
Telephone Number : 713-482-7037
Fax Number :
Provider Business Practice Location Address
First Line : 16903 RED OAK DR
Second Line : SUITE 165
City : HOUSTON
State : TX
Zip : 77090-3914
Country : US
Telephone Number : 713-482-7037
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/05/2010
Last Update Date : 02/05/2010

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Directions to “ MR. RANDALL MEDCALF L.M.T.” Practice Location

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