Provider Demographics
NPI:1194712968
Name:TOBON-RANDAL, BEATRIZ LEONOR (MD)
Entity type:Individual
Prefix:DR
First Name:BEATRIZ
Middle Name:LEONOR
Last Name:TOBON-RANDAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3945
Mailing Address - Street 2:DEPT 453
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77253-3945
Mailing Address - Country:US
Mailing Address - Phone:281-358-8114
Mailing Address - Fax:281-358-0609
Practice Address - Street 1:333 N TEXAS AVE
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4925
Practice Address - Country:US
Practice Address - Phone:281-335-1700
Practice Address - Fax:281-335-1708
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3611207L00000X, 207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8S5681OtherBLUECROSS BLUESHIELD
TXT0073230OtherDPS
TX8J3890OtherBLUECROSS BLUESHIELD
TXP00035629OtherRAILROAD MEDICARE
TXP00233612OtherRAILROAD MEDICARE
TX128218809Medicaid
TX128218813Medicaid
TX128218813Medicaid
TX128218813Medicaid
TX8F0076Medicare PIN
TX8A7829Medicare PIN