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General NPI Number Information
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NPI Number | 1235165820
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Entity Type | Organization
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Legal Business Name | MANJIT S RANDHAWA DO PA
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Dates
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Enumeration Date | 06/24/2006
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Last Update Date | 01/07/2021
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Provider Practice Location Address
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Address Line | 1980 EAST MULBERRY ST
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City | ANGLETON
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State | TX
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Zip | 77515
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Country | US
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Telephone | 979-848-3068
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Fax | 979-849-1423
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Provider Business Mailing Address
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Address Line | 1980 EAST MULBERRY ST
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City | ANGLETON
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State | TX
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Zip | 77515
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Country | US
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Telephone | 979-848-3068
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Fax | 979-849-1423
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | RITA RANDHAWA
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Credential |
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Telephone | 979-848-3068
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | J4464
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License Number State | TX
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