Niti Randhawa,M.D., PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

K2988 Issued in TX

Legal business name

NITI RANDHAWA,M.D., PA

Practice address

12200 Park Central Dr Ste 189
Dallas, TX 75251-2116

Phone

(469) 584-8480

Fax

(469) 587-8484

NPI assigned

Sep 25, 2008

Organization subpart

No

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

Authorized official

Name

Ninety Nine Credentialing Services

Title

Credentialing

Phone

(972) 792-5700

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1222300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1649420787",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9101 LBJ FREEWAY",
            "address_2": "STE 710",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752431912",
            "telephone_number": "972-792-5700",
            "fax_number": "214-506-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 PARK CENTRAL DR STE 189",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752512116",
            "telephone_number": "469-584-8480",
            "fax_number": "469-587-8484"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12200 Paek CentraL Drive",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75251",
            "country_code": "US",
            "telephone_number": "972-701-0199",
            "fax_number": "972-701-0201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "NITI RANDHAWA,M.D., PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-25",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CREDENTIALING SERVICES",
        "authorized_official_first_name": "NINETY NINE",
        "authorized_official_title_or_position": "CREDENTIALING",
        "authorized_official_telephone_number": "972-792-5700"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "K2988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "193400000X",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TX LICENSE",
            "identifier": "K2988",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in Dallas, TX
• Providers in Dallas, 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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.