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General NPI Number Information
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NPI Number | 1609824978
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Entity Type | Individual
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Provider Name | RANDALL PARKER KIRBY M.D., F.A.C.S.
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Gender | Male
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 06/01/2020
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Provider Practice Location Address
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Address Line | 9301 N CENTRAL EXPY, TWR 2 STE 180A
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City | DALLAS
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State | TX
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Zip | 75231-0822
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Country | US
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Telephone | 214-253-0170
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Fax | 214-253-0171
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Provider Business Mailing Address
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Address Line | PO BOX 650759
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City | DALLAS
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State | TX
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Zip | 75265-0759
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Country | US
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Telephone | 214-253-0170
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Fax | 214-253-0171
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | H5716
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | H5716
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License Number State | TX
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