Provider Demographics
NPI:1356984660
Name:DUNCAN, RANDALL PRESTON (CPO)
Entity type:Individual
Prefix:MR
First Name:RANDALL
Middle Name:PRESTON
Last Name:DUNCAN
Suffix:
Gender:M
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8804 PRIEST MEADOW CT
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75071-5977
Mailing Address - Country:US
Mailing Address - Phone:214-803-1108
Mailing Address - Fax:888-423-0215
Practice Address - Street 1:1918 UNIVERSITY BUSINESS DR STE 505
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-5805
Practice Address - Country:US
Practice Address - Phone:469-461-1515
Practice Address - Fax:888-423-0215
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-21
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1218222Z00000X, 224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetistGroup - Multi-Specialty
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotistGroup - Multi-Specialty