Dr. Gregory Dwight Randolph
Oral and Maxillofacial Surgeon
7300 Blanco Rd Ste 100
San Antonio
, Texas 78216-4937
Dr. Gregory Dwight Randolph
Oral and Maxillofacial Surgeon
7300 Blanco Rd Ste 100
San Antonio
, Texas 78216-4937
(210) 344-9118
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Gregory Dwight Randolph
- 7300 Blanco Rd Ste 100
- San Antonio, TX
- Zip : 78216-4937
- Fax : (210) 344-9118
- Phone : (210) 344-9898
Second Address
- Dr. Gregory Dwight Randolph
- 7300 Blanco Rd Ste 100
- San Antonio, TX
- Zip : 78216-4937
- Fax : (210) 344-9118
- Phone : (210) 344-9898
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | D12316 | TX |
National Provider Identifier
| NPI | 1023188299 |
|---|---|
| Provider Name | Dr. Gregory Dwight Randolph |
| First Address | San Antonio, TX 78216-4937 |
| Second Address | San Antonio, TX 78216-4937 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 08/11/2006 |
| Last Update Date | 28/12/2020 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| D12316 | STATE LICENSE NUMBER (01) | TX |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.