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General NPI Number Information
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NPI Number | 1881335602
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Entity Type | Individual
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Provider Name | INDERSUKHPREET RANDHAWA
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Gender | Male
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Dates
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Enumeration Date | 04/05/2022
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 6200 N LA CHOLLA BLVD
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City | TUCSON
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State | AZ
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Zip | 85741-3529
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Country | US
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Telephone | 520-742-9000
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Fax |
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Provider Business Mailing Address
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Address Line | 13128 WALNUT LAKE RD
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City | HOUSTON
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State | TX
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Zip | 77065-3223
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Country | US
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Telephone | 832-312-3729
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Fax |
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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