MRS. RANDA SUE VAJDAK (NPI# 1902172125) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902172125 |
| Entity Type | Individual |
| Full Name | MRS. RANDA SUE VAJDAK |
| Credential | PA-C |
| Practice Address |
3740 Copperfield Dr. Ste 105 Bryan TX 77802 |
| Practice Telephone | 9797761660 |
| Practice Fax Number | 9797761314 |
| Mailing Telephone | 9797761660 |
| Mailing Fax Number | 9797761314 |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2012-04-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 364SM0705X |
Clinical Nurse Specialist Specialization: Medical-Surgical |
PA02991 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
3740 COPPERFIELD DR. STE 105 |
| City | BRYAN |
| State | TX |
| Zip Code | 77802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013476951 | Andrea Pittman | Student in an Organized Health Care Education/Training Program | Primary Care Medicine Department, College of Medicine, 2900 East 29th Street, Bryan, TX 77802 | 2019-03-19 |
| 1942789110 | Alicia Diane Ates | Dentist | 3001 Wildflower Drive, Suite #511, Bryan, TX 77802 | 2018-08-09 |
| 1588151682 | Metx LLC | Audiologist-Hearing Aid Fitter | 3030 E 29th St Ste 102, Bryan, TX 77802 | 2018-04-16 |
| 1073047437 | Abbi Messer | Family Medicine | 2900 29th Street, Suite 100, Bryan, TX 77802 | 2017-04-12 |
| 1265885180 | Scott Andrew Thayer | Dentist | 3811 Stoneparc Dr, Bryan, TX 77802 | 2016-07-15 |
| 1255792123 | Phoebe Mathew | Pharmacist | 3312 East 29th Street, Bryan, TX 77802 | 2016-03-18 |
| 1801253810 | Pearl Coleshill | Specialist/Technologist | 3121 University Drive E., Suite 100, Bryan, TX 77802 | 2016-01-21 |
| 1265847750 | Wesley Danielle Daniels | Dietitian, Registered | 3900-c Carter Creek Pkway, Bryan, TX 77802 | 2014-06-24 |
| 1235549098 | Regina V. Robertson | Home Health | 1121 Briarcrest Dr., Suite 102, Bryan, TX 77802 | 2014-05-02 |
| 1982024238 | Lampstand Nursing and Rehabilitation, Lp | Skilled Nursing Facility | 2001 E 29th Street, Bryan, TX 77802 | 2014-04-24 |
| Find all providers in zip 77802 | ||||
| Taxonomy Code | 364SM0705X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Clinical Nurse Specialist |
| Specialization | Medical-Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760863922 | Christopher Hayes Cst Rn Bsn | Clinical Nurse Specialist | 608 Forest View Ct, Hurst, TX 76054-2821 | 2015-06-13 |
| 1902212012 | Amy Herrera | Clinical Nurse Specialist | 1222 Commerce St Apt 1605, Dallas, TX 75202-4358 | 2014-07-09 |
| 1023385564 | North Texas Pro Surgical Assist, LLC | Clinical Nurse Specialist | 2809 Branch Oaks Dr, Mckinney, TX 75070-8775 | 2011-11-29 |
| 1558640599 | Wayne Belaire Enterprises Pllc | Clinical Nurse Specialist | 3167 Mariannwood Dr, Port Neches, TX 77651-6015 | 2011-08-09 |
| 1770708927 | Laura L Bonner | Clinical Nurse Specialist | 2521 Lone Star Ln, Grapevine, TX 76051-4535 | 2007-04-14 |
| 1558419242 | Amanda H Wood | Clinical Nurse Specialist | 1415 Leigh Gardens Dr, Sugar Land, TX 77479-1884 | 2007-01-08 |
| 1487717096 | Karen Gilley | Clinical Nurse Specialist | 10113 Loving Trail Dr, Frisco, TX 75035-8175 | 2006-12-18 |
| 1871674580 | Christine Jean Walker | Clinical Nurse Specialist | 13521 Mane Ct, Justin, TX 76247-1110 | 2006-10-18 |
| 1720190762 | Linda J Kirk | Clinical Nurse Specialist | 215 E Quincy St Ste 610, San Antonio, TX 78215-2031 | 2006-08-31 |
| 1295842748 | Karen Sue Jordan | Clinical Nurse Specialist | 10950 Us Hwy 87 North, Box 38, Carlsbad, TX 76934-0038 | 2006-08-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.