Individual ProviderRandall G HeathNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3705 Medical Pkwy, Suite 570, Austin, TX 78705-1019(512) 454-2454PECOS EnrollmentBased on the most recent information from CMS, provider Randall G Heath does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1275515884Provider TypeIndividualFull NameHeath, Randall GCredentialCRNAGenderMaleSole ProprietorNoEnumeration Date11/18/2005Last Updated11/1/2007Contact InformationPractice LocationPractice Address3705 Medical Pkwy, Suite 570, Austin, TX 78705-1019Phone(512) 454-2454Fax(512) 454-1532Mailing LocationMailing Address3705 Medical Pkwy, Suite 570, Austin, TX 78705-1019Phone(512) 454-2454Fax(512) 454-1532Provider TaxonomiesCodeDescriptionLicenseCode367500000XPrimaryDescriptionNurse Anesthetist, Certified RegisteredPhysician Assistants & Advanced Practice Nursing ProvidersLicense45883TexasProvider IdentifiersIDDescriptionIssuerID87621CDescriptionOtherIssuerBC/BSTexasID89037801DescriptionMedicaidIssuerUnlistedTexas