Mackenzie Randolph
Nurse Practitioner, Family in Dallas, TX. Individual provider (NPI-1).
NPI number1073482014
StatusActive
Last updated in NPPESJun 3, 2026
Details
- NPI
- 1073482014
- Entity type
- Individual (NPI-1)
- Name
- Mackenzie Randolph
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Oct 29, 2025
- Certification date
- Jun 3, 2026
- Last updated
- Jun 3, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 1231411 | TX | Yes |
Practice location
3133 E Lemmon AveDallas, TX 75204-1411
Phone 214-599-2108
Mailing address
3133 E Lemmon AveDallas, TX 75204-1411
Phone 817-599-2108
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