Randle, Amanda
Randle, Amanda is an individual health care provider with primary practice located at 3201 S Loop 256 , Palestine TX 75801-6901. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Randle, Amanda can be contacted via phone (903) 723-0330.Contact Information
Primary practice address
3201 S Loop 256
Palestine TX 75801-6901
Phone: (903) 723-0330
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA14543 | Texas |
Profile Details
| NPI number | 1275907503 |
|---|---|
| LBN Legal business name | Randle, Amanda |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 24th, 2015 |
| Last updated | Sep 16th, 2022 - about 4 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 | 1275907503 | NPPES |
| Texas | MEDICAID | 425949101 |
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