Provider Demographics
NPI:1396822680
Name:BILLINGS, RANDAL LEE (OD)
Entity Type:Individual
Prefix:DR
First Name:RANDAL
Middle Name:LEE
Last Name:BILLINGS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3415 19TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-1201
Mailing Address - Country:US
Mailing Address - Phone:806-799-5001
Mailing Address - Fax:806-799-0515
Practice Address - Street 1:3415 19TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-1201
Practice Address - Country:US
Practice Address - Phone:806-799-5001
Practice Address - Fax:806-799-0515
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2011-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX02820TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX093485301Medicaid
TXT12208Medicare UPIN
TX093485301Medicaid