Provider Demographics
NPI:1114284999
Name:RANDHAWA, JAHANGIR ALI (MD)
Entity Type:Individual
Prefix:DR
First Name:JAHANGIR
Middle Name:ALI
Last Name:RANDHAWA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1505 LBJ FWY STE 700
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75234-6065
Mailing Address - Country:US
Mailing Address - Phone:214-358-2300
Mailing Address - Fax:214-579-6941
Practice Address - Street 1:4400 INTERSTATE HIGHWAY 30 W STE 300
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:TX
Practice Address - Zip Code:75402-4643
Practice Address - Country:US
Practice Address - Phone:214-358-2300
Practice Address - Fax:214-579-6994
Is Sole Proprietor?:No
Enumeration Date:2012-04-18
Last Update Date:2024-02-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXS0214207RN0300X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS0214OtherTEXAS MEDICAL LICENSE