Wilcox, Randall Dean

Wilcox, Randall Dean is an sole proprietor health care provider with primary practice located at 383 Fossil View Rd , Las Cruces NM 88007. He recently has 6 registered licenses in different health care specialties including Other Service Providers / Contractor, Agencies / Home Health, Laboratories / Clinical Medical Laboratory, Nursing & Custodial Care Facilities / Adult Care Home, Transportation Services / Private Vehicle, Technologists, Technicians & Other Technical Service Providers / Phlebotomy. Technologists, Technicians & Other Technical Service Providers / Phlebotomy is his primary health care specialty. Wilcox, Randall Dean can be contacted via phone (575) 520-3254.

Contact Information

Primary practice address
383 Fossil View Rd Las Cruces NM 88007
Phone: (575) 520-3254
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Contractor 171W00000X
Agencies / Home Health 251E00000X
Laboratories / Clinical Medical Laboratory 291U00000X
Nursing & Custodial Care Facilities / Adult Care Home 311ZA0620X
Transportation Services / Private Vehicle 347C00000X
Technologists, Technicians & Other Technical Service Providers / Phlebotomy 246RP1900X New Mexico

Profile Details

NPI number 1144592304
LBN Legal business name Wilcox, Randall Dean
Credentials LAB DIRECTOR
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 3rd, 2012
Last updated Mar 15th, 2019 - about 6 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 1144592304 NPPES
New Mexico MEDICAID 291U00000X
New Mexico MEDICAID 347C00000X
New Mexico MEDICAID 311ZA0620X
New Mexico MEDICAID 251E00000X
New Mexico MEDICAID 1144592304
New Mexico MEDICAID 246RP19000X-PHEBOTOM

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