Nacogdoches Neurosurgery, P.a.

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

Legal business name

NACOGDOCHES NEUROSURGERY, P.A.

Practice address

5500 North St
Nacogdoches, TX 75965-1372

Phone

(936) 560-6999

Fax

(936) 560-9139

NPI assigned

Apr 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. James Michael Randle, M.D.

Title

President

Phone

(936) 560-6999

Specialties & licenses 1

Addresses

Other identifiers 4

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Scott Steven-Flynn Foxworth, PA-C

  • Physician Assistant
  • Edinburg, TX
  • NPI 1255350708
  NPD (past)
• Debbie A. Wallace, PA-C

  • Medical Physician Assistant
  • Naples, FL
  • NPI 1881634327
  NPD (past)

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

{
    "created_epoch": "1145404800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318809600000",
    "number": "1942265194",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5500 NORTH ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651372",
            "telephone_number": "936-560-6999",
            "fax_number": "936-560-9139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 NORTH ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759651372",
            "telephone_number": "936-560-6999",
            "fax_number": "936-560-9139"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NACOGDOCHES NEUROSURGERY, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-19",
        "last_updated": "2011-10-17",
        "status": "A",
        "authorized_official_last_name": "RANDLE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "936-560-6999",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Neurological Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA - RAILROAD MEDICARE",
            "identifier": "CJ8921",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WORKERS COMPENSATION",
            "identifier": "MDK8445",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "0096DQ",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "080356101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Nacogdoches Podiatry PLLC
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• Neurological Surgery Physician in Nacogdoches, TX
• Providers in Nacogdoches, TX by specialty
• Neurological Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2011; 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.