Provider Demographics
NPI:1720089592
Name:PIERCE, KARL RANDY (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:RANDY
Last Name:PIERCE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:K
Other - Middle Name:RANDY
Other - Last Name:PIERCE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:5011 BURNET RD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-2611
Mailing Address - Country:US
Mailing Address - Phone:512-583-2020
Mailing Address - Fax:512-744-2020
Practice Address - Street 1:5011 BURNET RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-2611
Practice Address - Country:US
Practice Address - Phone:512-583-2020
Practice Address - Fax:512-744-2020
Is Sole Proprietor?:No
Enumeration Date:2005-08-03
Last Update Date:2013-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8325207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
3305739OtherBLUE LINK
P00141002OtherRAILROAD MEDICARE
8M5281OtherBC
TX8B9306Medicaid
4471011OtherAETNA
116987202Medicare ID - Type Unspecified
3305739OtherBLUE LINK
4471011OtherAETNA