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
Fax: (806) 771-8809
Website:

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1013060946 NPPES
Texas MEDICAID 099265302

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