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General NPI Number Information
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NPI Number | 1487848750
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Entity Type | Organization
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Legal Business Name | JOHN T RANDOLPH JR DC PC
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Dates
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Enumeration Date | 08/30/2007
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Last Update Date | 09/02/2008
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Provider Practice Location Address
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Address Line | 10223 W BROADWAY ST SUITE C
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City | PEARLAND
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State | TX
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Zip | 77584-7881
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Country | US
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Telephone | 713-436-2600
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Fax | 713-436-2645
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Provider Business Mailing Address
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Address Line | 10223 W BROADWAY ST SUITE C
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City | PEARLAND
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State | TX
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Zip | 77584-7881
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Country | US
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Telephone | 713-436-2600
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Fax | 713-436-2645
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN T RANDOLPH JR.
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Credential | DO
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Telephone | 713-451-1784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC5911
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 5911
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License Number State | TX
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