Provider Demographics
NPI:1073622825
Name:DEAL, RANDOLPH (PHD)
Entity Type:Individual
Prefix:DR
First Name:RANDOLPH
Middle Name:
Last Name:DEAL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10914 HEFNER POINTE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-5066
Mailing Address - Country:US
Mailing Address - Phone:405-608-8833
Mailing Address - Fax:405-608-8818
Practice Address - Street 1:10914 HEFNER POINTE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-5066
Practice Address - Country:US
Practice Address - Phone:405-608-8833
Practice Address - Fax:405-608-8188
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3002235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist