Provider Demographics
NPI:1649494683
Name:RANDY A. BIRKEN, M.D.,P.A.
Entity type:Organization
Organization Name:RANDY A. BIRKEN, M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RANDY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BIRKEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:281-893-1246
Mailing Address - Street 1:4185 TECHNOLOGY FOREST BLVD
Mailing Address - Street 2:SUITE 190
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-2004
Mailing Address - Country:US
Mailing Address - Phone:281-893-1246
Mailing Address - Fax:832-813-7462
Practice Address - Street 1:4185 TECHNOLOGY FOREST BLVD
Practice Address - Street 2:SUITE 190
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77381-2004
Practice Address - Country:US
Practice Address - Phone:281-893-1246
Practice Address - Fax:832-813-7462
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-12
Last Update Date:2010-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty