Randle, Amanda

Randle, Amanda is an individual health care provider with primary practice located at 3201 S Loop 256 , Palestine TX 75801-6901. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Randle, Amanda can be contacted via phone (903) 723-0330.

Contact Information

Primary practice address
3201 S Loop 256 Palestine TX 75801-6901
Phone: (903) 723-0330
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA14543 Texas

Profile Details

NPI number 1275907503
LBN Legal business name Randle, Amanda
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 24th, 2015
Last updated Sep 16th, 2022 - about 3 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275907503 NPPES
Texas MEDICAID 425949101

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