DONALD A RANDOLPH, JR., MD, PA
Medical Practice at Carroll Ave, Dallas, TX

License number
Texas M1307
Category
Medical Practice
Type
Sports Medicine
Owner
Name: DR. DONALD A RANDOLPH JR. M.D.
Title: DIRECTOR
Phone: (214) 824-7744
Address
Address
1015 N Carroll Ave #2000, Dallas, TX 75204
National Provider ID: 1588856728
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DONALD A. RANDOLPH, JR., M.D., PA

Dallas, TX

Status:
Inactive
Doing business as:
Donald A. Randolph, Jr., M.D., PA
Registration:
Oct 10, 2006
Addresses:
9201 Garland Rd APT 817A, Dallas, TX 75218 (Mailing)
1015 N Carroll Ave, Dallas, TX 75204
State ID:
0800718030
Business type:
Professional Association
President, Treasurer, Secretary, Director, Member, Vice-President:
Donald Appleby Randolph President, Treasurer, Secretary, Director, Member, Vice-President, inactive
Agent:
Donald A Randolph Jr,9201 Garland Rd 817A, Dallas, TX 75218 (Physical)
TIN:
32035108698

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