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General NPI Number Information
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NPI Number | 1932198611
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Entity Type | Individual
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Provider Name | DAVID JOSEPH RANDELL DO
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Gender | Male
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 07/23/2013
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Provider Practice Location Address
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Address Line | 6250 REGIONAL PLZ SUITE 1010
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City | ABILENE
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State | TX
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Zip | 79606-5262
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Country | US
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Telephone | 325-428-5500
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Fax | 325-428-5519
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Provider Business Mailing Address
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Address Line | 35 WINDMILL CIR
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City | ABILENE
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State | TX
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Zip | 79606-5234
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Country | US
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Telephone | 325-698-4221
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Fax | 325-698-6951
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | H5795
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License Number State | TX
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