Provider Demographics
NPI:1922010347
Name:ANDREWS, RANDOLPH J (DC)
Entity Type:Individual
Prefix:DR
First Name:RANDOLPH
Middle Name:J
Last Name:ANDREWS
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 1:2506 S NELSON ST
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79103-4330
Mailing Address - Country:US
Mailing Address - Phone:806-372-3988
Mailing Address - Fax:806-372-1839
Practice Address - Street 1:2506 S NELSON ST
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79103-4330
Practice Address - Country:US
Practice Address - Phone:806-372-3988
Practice Address - Fax:806-372-1839
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2961111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1544926-01Medicaid
TX1544926-01Medicaid
TX751909487OtherTAX ID NUMBER