Randa Sue Vajdak, PA-C

Primary specialty

Medical-Surgical Clinical Nurse SpecialistTaxonomy code 364SM0705X

License

PA02991 Issued in TX

Practice address

3740 Copperfield Dr.
Ste 105
Bryan, TX 77802

Phone

(979) 776-1660

Fax

(979) 776-1314

NPI assigned

Apr 2, 2012

Sex

Female

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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

• Owens Interventional Pain Management PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Bryan, TX
  • NPI 1134538093
  Medicare reassignment
• Partners in Chronic Disease Management Inc

  dba Medical House Call Associates

  • Family Medicine Physician
  • Lubbock, TX
  • NPI 1033438635
  NPD (past)
• Rapidcare Clinic PA

  • Clinic/Center
  • Leander, TX
  • NPI 1013094168
  NPD (past)

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

{
    "created_epoch": "1333324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333324800000",
    "number": "1902172125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3740 COPPERFIELD DR.",
            "address_2": "STE 105",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "77802",
            "telephone_number": "979-776-1660",
            "fax_number": "979-776-1314"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3740 COPPERFIELD DR.",
            "address_2": "STE 105",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "77802",
            "telephone_number": "979-776-1660",
            "fax_number": "979-776-1314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAJDAK",
        "first_name": "RANDA",
        "middle_name": "SUE",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-04-02",
        "last_updated": "2012-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SM0705X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Medical-Surgical",
            "state": "TX",
            "license": "PA02991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• University Sports & Family Medicine (University Sports Medicine)
• Marcelo David Uriegas, DDS
• Shelby Ryan Urrutia
• Urso Kramr LLP (University Dental Associates)
• Steve P Urso, DDS
• Mark Andrew Valasek, MD PHD
• Olga Lydia Valdez
• Belinda Valenzuela, LPC-ASSOCIATE
• Miraflor Valino-Pak, PT
• Kelly Van Cleave, O.D.

• Medical-Surgical Clinical Nurse Specialist in Bryan, TX
• Providers in Bryan, TX by specialty
• Medical-Surgical Clinical Nurse Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2012; 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.