Derrick Randdolf, MD Valid NPI
Individual provider · Family Medicine Physician · Odessa, TX
- NPI
- 1104205343
- Type
- Individual (Type 1)
- Primary specialty
- Family Medicine Physician (Family Medicine)
- Specialty group
- Allopathic & Osteopathic Physicians
- Taxonomy code
- 207Q00000X
- License number
- R4622 (TX)
- Sex
- Male
- Sole proprietor
- No
- Enumerated
- 2015-05-20
- Last updated
- 2025-02-26
Practice location
701 W 5th St
Odessa, TX 79763-4206
(432) 703-5375