A Randall Moody II MD PA

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

A RANDALL MOODY II MD PA

Practice address

5788 Eckhert Rd
Frank M. Tejeda VA Outpatient Clinic, C&P Department
San Antonio, TX 78240-3900

Phone

(830) 285-4096

Fax

(830) 896-3310

NPI assigned

Jul 2, 2006

Organization subpart

No

Name

Austin Randall Moody II, MD

Title

MD

Phone

(830) 285-4096

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 28, 2013.

{
    "created_epoch": "1151798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1374969600000",
    "number": "1740219682",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5788 ECKHERT RD",
            "address_2": "FRANK M. TEJEDA VA OUTPATIENT CLINIC, C& P DEPARTMENT",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403900",
            "telephone_number": "830-285-4096",
            "fax_number": "830-896-3310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5788 ECKHERT RD",
            "address_2": "FRANK M. TEJEDA VA OUTPATIENT CLINIC, C&P DEPARTMENT",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782403900",
            "telephone_number": "830-285-4096",
            "fax_number": "830-896-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A RANDALL MOODY II MD PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-02",
        "last_updated": "2013-07-28",
        "status": "A",
        "authorized_official_last_name": "MOODY",
        "authorized_official_first_name": "AUSTIN",
        "authorized_official_middle_name": "RANDALL",
        "authorized_official_title_or_position": "MD",
        "authorized_official_telephone_number": "830-285-4096",
        "authorized_official_name_suffix": "II",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "178696401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2013; 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.