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General NPI Number Information
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NPI Number | 1609903756
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Entity Type | Organization
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Legal Business Name | DR SURINDA K RANDHAWA INC
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Dates
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Enumeration Date | 02/27/2007
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Last Update Date | 09/17/2007
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Provider Practice Location Address
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Address Line | 13925 MIDDLEBERRY RD
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City | EDMOND
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State | OK
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Zip | 73013-7039
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Country | US
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Telephone | 405-948-7707
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Fax | 405-702-0007
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Provider Business Mailing Address
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Address Line | PO BOX 989
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City | EDMOND
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State | OK
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Zip | 73083-0989
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Country | US
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Telephone | 405-948-7707
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Fax | 405-702-0007
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. CHITTRANJAN VERMA
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Credential |
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Telephone | 405-948-7707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 18871
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License Number State | OK
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