Randolph, Mark B

Randolph, Mark B is an sole proprietor health care provider with primary practice located at 1920 Corporate Dr Suite 208, San Marcos TX 78666-6077. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Randolph, Mark B can be contacted via phone (512) 878-6330.

Contact Information

Primary practice address
1920 Corporate Dr Suite 208 San Marcos TX 78666-6077
Phone: (512) 878-6330
Fax: (512) 878-6941
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X L8483 Texas

Profile Details

NPI number 1982677209
LBN Legal business name Randolph, Mark B
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 8th, 2006
Last updated Aug 17th, 2012 - about 12 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 1982677209 NPPES
Texas Other L8483 STATE LIC NUMBER

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