Provider Demographics
NPI:1679195226
Name:SAMPSON, RANDI LYNN (PHARM D)
Entity Type:Individual
Prefix:
First Name:RANDI
Middle Name:LYNN
Last Name:SAMPSON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 ENCINO PT
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-2030
Mailing Address - Country:US
Mailing Address - Phone:423-794-7508
Mailing Address - Fax:
Practice Address - Street 1:6363 RITTIMAN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78218-4700
Practice Address - Country:US
Practice Address - Phone:210-666-4244
Practice Address - Fax:210-666-5759
Is Sole Proprietor?:No
Enumeration Date:2020-05-16
Last Update Date:2020-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX59327183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist