Randal K Jacks, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G8195 Issued in TX

Practice address

774 Landa St
New Braunfels, TX 78130-6114

Phone

(830) 625-0305

Fax

(830) 625-2693

NPI assigned

Feb 10, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment NPD
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296604800000",
    "number": "1356314124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 LANDA ST",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781306114",
            "telephone_number": "830-625-0305",
            "fax_number": "830-625-2693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 LANDA ST",
            "city": "NEW BRAUNFELS",
            "state": "TX",
            "postal_code": "781306114",
            "telephone_number": "830-625-0305",
            "fax_number": "830-625-2693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKS",
        "first_name": "RANDAL",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-10",
        "last_updated": "2011-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "G8195",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irvin Sahni, M.D. PA.
• Karrie Itz-Thompson, R.D., L.D.
• Rachel Spencer Ivanov, MSN, APRN, PMHNP
• Emily Annmarie Ivey, LPC
• Jackie Engelhardt Counseling PLLC
• Jackson Savage P.L.L.C.
• Candace McKenzie Jackson, LPC
• Kimberly Jacobs, LAC
• Rinki Jain
• Brandon Reagan James, D.P.M.

• Family Medicine Physician in New Braunfels, TX
• Providers in New Braunfels, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.