Provider Demographics
NPI:1447242995
Name:SCHIFFER, RANDOLPH B (MD)
Entity Type:Individual
Prefix:
First Name:RANDOLPH
Middle Name:B
Last Name:SCHIFFER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5865
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79408-5865
Mailing Address - Country:US
Mailing Address - Phone:806-743-2898
Mailing Address - Fax:806-743-2787
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:1C102
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-8103
Practice Address - Country:US
Practice Address - Phone:806-743-2800
Practice Address - Fax:806-743-1668
Is Sole Proprietor?:No
Enumeration Date:2005-08-19
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK88312084N0400X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX88701SOtherBCBS
NM52495Medicaid
NMA286OtherTRIWEST
NMT9563Medicaid
TX82845ZOtherHMO BLUE
NM52495OtherPRESBYTERIAN COMMERCIAL
TX88701SOtherBCBS
NMT9563Medicaid