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A RANDALL MOODY II MD PA NPI 1740219682


NPI Information

NPI: 1740219682
Provider Name: A RANDALL MOODY II MD PA
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Organization

Specialization: Neurology

Address:
5788 ECKHERT RD
FRANK M. TEJEDA VA OUTPATIENT CLINIC, C&P DEPARTMENT
SAN ANTONIO, TX
ZIP 78240
Phone: (830) 285-4096
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A RANDALL MOODY II MD PA is a neurology psychiatry neurology in San Antonio, TX. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. A RANDALL MOODY II MD PA NPI is 1740219682. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

5788 ECKHERT RD
FRANK M. TEJEDA VA OUTPATIENT CLINIC, C&P DEPARTMENT
SAN ANTONIO, TX
ZIP 78240-900
Phone: (830) 285-4096
Fax: (830) 896-3310

The provider's authorized official is Austin Randall Moody .
The authorized official title is Md and has the following contact phone number (830) 285-4096.

The enumeration date for this NPI number is 7/2/2006 and was last updated on 7/28/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
12084N0400XPsychiatry & NeurologyNeurologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1C19503MEDICARE UPIN
28F1823MEDICARE PINTEXAS
300877ZMEDICARE PINTEXAS
4178696401MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.