Dr. Randall M. Vanover, M.D.
Internal Medicine in San Antonio, TX. Individual provider (NPI-1).
NPI number1700937992
StatusActive
Last updated in NPPESApr 25, 2012
Details
- NPI
- 1700937992
- Entity type
- Individual (NPI-1)
- Name
- Dr. Randall M. Vanover
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jan 15, 2007
- Last updated
- Apr 25, 2012
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
- Medicare opt-out
- Jul 1, 2016 to Jul 1, 2028
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | G1570 | TX | Yes |
Practice location
13409 George RdSan Antonio, TX 78230-3064
Phone 210-492-8922 · Fax 210-479-2010
Mailing address
13409 George RdSan Antonio, TX 78230-3064
Phone 210-492-8922 · Fax 210-479-2010
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