NPI age
20 years
Enumerated 2006-02-15
● Active Type 2 · Organization
12th Medical Group Randolph
12th Medical Group Randolph is 1 of 62 clinic/center organizations in Texas.
Primary specialty
Clinic/Center
Plus 2 secondary
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Hansken
Air Force Uniform Business Office
Last NPPES update
2010-11-15
Source: monthly bulk 2026-05
How this organization compares
Across 62 active clinic/center providers in Texas.
NPI age
20 years
↑ 2 yr above median
Practice locations
1
0 secondary on file
Subspecialties
2
In the 12% of peers with subspecialties
NPI lifetime · 2006 → 2026
2006-02Enumerated in NPPES
2006
2026
Where they practice
Primary practice location
221 3rd St W, Bldg 1040
Randolph A F B, TX 781504800
Mailing address
221 3rd St W, Bldg 1040
Randolph A F B, TX 781504800
Authorized official
Serena Lynn Hansken
Air Force Uniform Business Office
📞 7035886419
Individual providers at this organization
11 individual providers on file at this primary practice address.
- Catherine Biersack, M.D. Pediatrics NPI 1003805623
- David Carey, PA-C Physician Assistant NPI 1841247814
- Cesario Ferrer, MD, MPH Preventive Medicine NPI 1871555607
- John Hudson, DDS Dentist NPI 1518954791
- James Kopp, MD Family Medicine NPI 1366416372
- James Little, M.D. Preventive Medicine NPI 1265522718
- John McDonald, DDS Dentist NPI 1023004405
- Richard Mooney, M.D. Family Medicine NPI 1750358305
- Jesse Richardson, MSPT Specialist NPI 1801889860
- Phillip Sandefur, DDS Dentist NPI 1306993043
- Steven Stanek, O.D. Optometrist NPI 1528060027
Specialties
-
Clinic/Center PrimaryThe Defense Health Program or U.S. Coast Guard funded "fixed" facilities or distinct parts of a facility, providing outpatient medical and dental services, primarily for Uniformed Services beneficiaries. A "fixed" facility is a...
-
Clinic/CenterThat part of a "fixed" (non-temporary, non-deployed) DoD or Coast Guard entity furnishing surgical procedures requiring medically supervised recovery. Similar to a civilian ambulatory surgical center. May be in shared resources with a...
-
Military/U.S. Coast Guard PharmacyA Department of Defense (DoD) or U.S. Coast Guard entity whose primary function is to store, prepare and dispense pharmaceuticals and other associated items to Uniformed Services beneficiaries. These pharmacies may be associated with a...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (TX) | 4512908 | NCPDP |
Other names on file (1)
Doing-business-as, former, and alternate names recorded by NPPES.
-
Randolph AFB Clinic
Practice context
Multi-provider organization. 11 individual providers on file at this primary address.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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