Randel, Mark Alford
Randel, Mark Alford is an individual health care provider with primary practice located at 3618 N University Dr , Nacogdoches TX 75965-2539. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Vascular Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Randel, Mark Alford can be contacted via phone (936) 568-9993.Contact Information
Primary practice address
3618 N University Dr
Nacogdoches TX 75965-2539
Phone: (936) 568-9993
Fax: (936) 568-9996
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | H6529 | Texas |
| Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 16951 | Oklahoma |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | H6529 | Texas |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 16951 | Oklahoma |
Profile Details
| NPI number | 1629103619 |
|---|---|
| LBN Legal business name | Randel, Mark Alford |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 22nd, 2007 |
| Last updated | Oct 18th, 2015 - about 9 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 | 1629103619 | NPPES |
| Texas | MEDICAID | 030062603 | |
| Texas | Other | 00323J | |
| Texas | MEDICAID | 030062604 | |
| Texas | MEDICAID | 030062602 | |
| Texas | Other | 8CN590 |
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