MARK RANDOLPH MD PA
Ambulatory Health at Corporate Dr, San Marcos, TX

License number
Texas L8483
Category
Ambulatory Health
Type
Primary Care
Owner
Name: DR. MARK B RANDOLPH M.D.
Title: PHYSICIAN
Phone: (512) 878-6330
Address
Address
1920 Corporate Dr SUITE 208, San Marcos, TX 78666
National Provider ID: 1891859476
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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MARK RANDOLPH, MD, PA

San Marcos, TX

Registration:
Jun 20, 2005
Addresses:
1920 Corporate Dr STE 208, San Marcos, TX 78666 (Mailing)
1921 Corporate Dr, San Marcos, TX 78666
State ID:
0800508354
Business type:
Professional Association
President, Treasurer, Secretary, Director, Member, Vice-President:
Mark B. Randolph (President, Treasurer, Secretary, Director, Member, Vice-President)
TIN:
32035382921

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