Mikulik, Randall W
Mikulik, Randall W is an sole proprietor health care provider with primary practice located at 1533 S Brownlee Blvd Ste 100 , Corpus Christi TX 78404-3131. He recently has 2 registered licenses in different health care specialties including Dental Providers / Endodontics, Dental Providers / General Practice. Dental Providers / General Practice is his primary health care specialty. Mikulik, Randall W can be contacted via phone (808) 218-6650.Contact Information
Primary practice address
1533 S Brownlee Blvd Ste 100
Corpus Christi TX 78404-3131
Phone: (808) 218-6650
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Endodontics | 1223E0200X | DT-2054 | Hawaii |
| Dental Providers / General Practice | 1223G0001X | DT-2054 | Hawaii |
| Dental Providers / General Practice | 1223G0001X | 19915 | Texas |
Profile Details
| NPI number | 1073698544 |
|---|---|
| LBN Legal business name | Mikulik, Randall W |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 25th, 2006 |
| Last updated | May 12th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1073698544 | NPPES |
| Hawaii | Other | 241943 | HMSA |
| Hawaii | Other | 2054 | HMSA |
| Hawaii | MEDICAID | 00992101 | HMSA |
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