Randolph, Patrick David
Randolph, Patrick David is an sole proprietor health care provider with primary practice located at 5147 69Th St Ste D , Lubbock TX 79424-1646. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Randolph, Patrick David can be contacted via phone (806) 771-8808.Contact Information
Primary practice address
5147 69Th St Ste D
Lubbock TX 79424-1646
Phone: (806) 771-8808
Fax: (806) 771-8809
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 24796 | Texas |
Profile Details
NPI number | 1013060946 |
---|---|
LBN Legal business name | Randolph, Patrick David |
Credentials | PH.D. |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jan 22nd, 2007 |
Last updated | Jan 2nd, 2024 - about 11 months 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 | 1013060946 | NPPES |
Texas | MEDICAID | 099265302 |
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