Provider Demographics
NPI:1538206305
Name:BARRON, RANDALL M (DO)
Entity type:Individual
Prefix:
First Name:RANDALL
Middle Name:M
Last Name:BARRON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:109 S PARK DR
Mailing Address - Street 2:
Mailing Address - City:BROWNWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:76801-5917
Mailing Address - Country:US
Mailing Address - Phone:325-643-3010
Mailing Address - Fax:325-643-2978
Practice Address - Street 1:2005 HIGHWAY 183 N
Practice Address - Street 2:
Practice Address - City:EARLY
Practice Address - State:TX
Practice Address - Zip Code:76802-2188
Practice Address - Country:US
Practice Address - Phone:325-643-3010
Practice Address - Fax:325-643-2978
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXJ6321207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF93577Medicare UPIN