Individual provider Active NPI

Christine V Randall, PH.D.

  • Clinical Neuropsychologist
  • The Woodlands, TX
National Provider Identifier
1780621243
Registry record updated Aug 27, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
31592 Issued in TX
Practice address
25810 Oak Ridge Dr
The Woodlands, TX 77380-2016
Phone
(281) 364-0067
Fax
(281) 364-0712
NPI assigned
Jun 1, 2006
Last updated
Aug 27, 2010By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 27, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X 31592 TX Primary

Addresses

Primary practice location

25810 Oak Ridge Dr
The Woodlands, TX 77380-2016

Mailing address

25810 Oak Ridge Dr
The Woodlands, TX 77380-2016
Phone (281) 364-0067

Other identifiers 1

IdentifierTypeStateIssuer
7235784OtherTXAETNA ID

Other names 1

  • Christine V Hudson Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
31592TXMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1282867200000",
    "number": "1780621243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25810 OAK RIDGE DR",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773802016",
            "telephone_number": "281-364-0067",
            "fax_number": "281-364-0712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25810 OAK RIDGE DR",
            "city": "THE WOODLANDS",
            "state": "TX",
            "postal_code": "773802016",
            "telephone_number": "281-364-0067",
            "fax_number": "281-364-0712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RANDALL",
        "first_name": "CHRISTINE",
        "middle_name": "V",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-06-01",
        "last_updated": "2010-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "TX",
            "license": "31592",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA ID",
            "identifier": "7235784",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CHRISTINE",
            "last_name": "HUDSON",
            "middle_name": "V",
            "credential": "PH.D.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in The Woodlands, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2010; 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.