Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mackenzie Randolph

Individual provider Family Nurse Practitioner · NPI 1073482014

Mackenzie Randolph is a Nurse Practitioner in Dallas, Texas. Qualified in 2025, 1 year ago. Licensed in Texas.

Years since qualifying
1
Licensed in
TX
In the registry since
2025

Practice location Address checks out

3133 E Lemmon Ave
Dallas, TX 75204-1411
Phone: (214) 599-2108
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 1231411 (TX)

Record details

NPI number1073482014
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 29, 2025
Last updated in NPPESJune 3, 2026
Certification dateJune 3, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Accepts Medicare assignment Not indicated

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