Randy Ranshawn Moore (NPI# 1053627265, PAC ID# 6103941844) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is PHYSICIAN ASSISTANT.
| Nation Provider ID (NPI) | 1053627265 |
| PAC ID by PECOS | 6103941844 |
| Professional Enrollment ID | I20100917000520 |
| Full Name | Randy Ranshawn Moore |
| Organization Legal Name | LONGVIEW WELLNESS CENTER INC |
| Address |
1107 E Marshall Ave Wellness Pointe Longview TX 75601-5602 |
| Phone Number | 9037582610 |
| Gender | M |
| Graduation Year | 2010 |
| Primary Specialty | PHYSICIAN ASSISTANT |
| Group Practice PAC ID | 1254367766 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | M |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 450032 | GOOD SHEPHERD MEDICAL CENTER MARSHALL |
| Address | Phone | Organization |
|---|---|---|
| 1107 E Marshall Ave, Wellness Pointe, Longview, TX 75601-5602 | 9037582610 | LONGVIEW WELLNESS CENTER INC |
| Organization Legal Name | LONGVIEW WELLNESS CENTER INC |
| Physicians | 10 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Paul L Lin | Obstetrics/gynecology | Longview Wellness Center Inc | 1300 N 6th St A, Wellness Pointe, Longview, TX 75601-5567 |
| Marcy J Hall | Nurse Practitioner | Longview Wellness Center Inc | 1300 N 6th St A, Wellness Pointe, Longview, TX 75601-5567 |
| Ramon G Villafria | Family Medicine | Longview Wellness Center Inc | 1300 N 6th St A, Wellness Pointe, Longview, TX 75601-5567 |
| Monica G Mason | Nurse Practitioner | Longview Wellness Center Inc | 1107 E Marshall Ave, Wellness Pointe, Longview, TX 75601-5602 |
| Wendy Mckinnon | Nurse Practitioner | Longview Wellness Center Inc | 1107 E Marshall Ave, Wellness Pointe, Longview, TX 75601-5602 |
| John H Shum | Obstetrics/gynecology | Longview Wellness Center Inc | 1300 N 6th St A, Wellness Pointe, Longview, TX 75601-5567 |
| Marcus D Turney | Nurse Practitioner | Longview Wellness Center Inc | 1107 E Marshall Ave, Longview, TX 75601-5602 |
| Philip S Hunter | Family Practice | Longview Wellness Center Inc | 1107 E Marshall Ave, Longview, TX 75601-5602 |
| Meagan A Tanner | Nurse Practitioner | Longview Wellness Center Inc | 1107 E Marshall Ave, Longview, TX 75601-5602 |
| Street Address |
1107 E MARSHALL AVE WELLNESS POINTE |
| City | LONGVIEW |
| State | TX |
| Zip | 75601-5602 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Monica G Mason | Nurse Practitioner | Longview Wellness Center Inc | 1107 E Marshall Ave, Wellness Pointe, Longview, TX 75601-5602 |
| Wendy Mckinnon | Nurse Practitioner | Longview Wellness Center Inc | 1107 E Marshall Ave, Wellness Pointe, Longview, TX 75601-5602 |
| Marcus D Turney | Nurse Practitioner | Longview Wellness Center Inc | 1107 E Marshall Ave, Longview, TX 75601-5602 |
| Philip S Hunter | Family Practice | Longview Wellness Center Inc | 1107 E Marshall Ave, Longview, TX 75601-5602 |
| Meagan A Tanner | Nurse Practitioner | Longview Wellness Center Inc | 1107 E Marshall Ave, Longview, TX 75601-5602 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daytral Matasha Brown | Nurse Practitioner | 103 Woodbine Pl A, The Beverly Clinic, Longview, TX 75601-2912 | |
| Andrea M Marjason | Clinical Social Worker | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Michelle Ann Vess | Physician Assistant | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Donald Winsted | Psychologist, Clinical | 103 Woodbine Pl A, Longview, TX 75601-2912 | |
| Courtney Elizabeth Treat | Physician Assistant | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Jeremiah R Sanders | Nurse Practitioner | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Carrie D Hinton | Nurse Practitioner | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Gracie M Adkisson | Nurse Practitioner | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Longview, TX 75601-2912 |
| Debbie L Anderson | Clinical Social Worker | Sabine Valley Regional Mhmr Center | 107 Woodbine Pl, Sabine Valley Regional Mhmr, Longview, TX 75601-2912 |
| Thomas Jay Dehaven | Ophthalmology | Trinity Clinic | 1705 Judson Rd, Longview, TX 75601-2938 |
| Find all physicians in zip 75601 | |||
| City | LONGVIEW |
| Zip Code | 75601 |
| Specialty | PHYSICIAN ASSISTANT |
| City + Specialty | LONGVIEW + PHYSICIAN ASSISTANT |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.