Smith, Randy Lee
Smith, Randy Lee is an sole proprietor health care provider with primary practice located at 2908 Se Loop 820 , Fort Worth TX 76140-1019. He recently has 2 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Customized Equipment. Suppliers / Durable Medical Equipment & Medical Supplies is his primary health care specialty. Smith, Randy Lee can be contacted via phone (817) 590-8166.Contact Information
Primary practice address
2908 Se Loop 820
Fort Worth TX 76140-1019
Phone: (817) 590-8166
Fax: (817) 590-8277
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 421484921 | Texas |
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | Texas | |
| Suppliers / Customized Equipment | 332BC3200X | Texas | |
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X |
Profile Details
| NPI number | 1336173632 |
|---|---|
| LBN Legal business name | Smith, Randy Lee |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 10th, 2006 |
| Last updated | Mar 14th, 2016 - about 8 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 | 1336173632 | NPPES |
| Texas | MEDICAID | 1872004-03 | |
| Texas | MEDICAID | 1872004-05 | |
| Texas | MEDICAID | 1872004-01 |
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