| Doctor Name: | MR. RANDALL LEE SUNDERLAND |
| NPI Number: | 1386820793 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 707 E 17th St Del Rio, TX - 788407817 |
| Business Phone Number: | 8307682582 |
| Business Fax Number: | 8307680992 |
| Mailing Address: | 707 E 17th St, DEL RIO |
| State: | TX |
| Postal Code: | 788407817 |
| Phone Number: | 8307682582 |
| Fax Number: | 8307680992 |
| NPI Enumeration Date: | 01/15/2008 |
| NPI Last Update Date: | 01/16/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rehabilitation |
| Taxonomy Definition: | |