Provider Demographics
NPI:1891889408
Name:GRIFFIN, RANDY JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:JAMES
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12000 FORD RD
Mailing Address - Street 2:
Mailing Address - City:FARMERS BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:75234-7249
Mailing Address - Country:US
Mailing Address - Phone:214-883-3203
Mailing Address - Fax:972-534-1450
Practice Address - Street 1:12000 FORD RD
Practice Address - Street 2:240
Practice Address - City:FARMERS BRANCH
Practice Address - State:TX
Practice Address - Zip Code:75234-7249
Practice Address - Country:US
Practice Address - Phone:214-883-3203
Practice Address - Fax:972-534-1450
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2010-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4235 DC111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX601655Medicare PIN