PUBLIC VERIFICATION / PHYSICIAN PROFILE PHYSICIAN NAME: H BROOK RANDAL MD DATE: 03/08/2012 THE INFORMATION IN THIS BOX HAS BEEN VERIFIED BY THE TEXAS MEDICAL BOARD Date of Birth: 1951 License Number: G3943 Full Medical License Issuance Date: 02/27/1983 Expiration Date of Physician’s Annual Registration Permit: 05/31/2013 Registration Status: ACTIVE Registration Date: 02/27/1983 Disciplinary Status: NONE Disciplinary Date: NONE Licensure Status: NONE Licensure Date: NONE Medical School of Graduation: At the time of licensure, TMB verified the physician’s graduation from medical school as follows: UNIV OF TEXAS MEDICAL SCHOOL, SAN ANTONIO Medical School Graduation Year: 1982 TMB Filings, Actions and License Restrictions The Texas Medical Board has the following board actions against this physician. (This may include any formal complaints filed by TMB, as well as petitions and/or responses related to licensure contested matters, at the State Office of Administrative Hearings.) NONE Investigations by TMB of Medical Malpractice Section 164.201 of the Act requires that: the board review information relating to a physician against whom three or more malpractice claims have been reported within a five year period. Based on these reviews, the following investigations were conducted with the listed resolutions. NONE Status History Status history contains entries for any updates to the individual’s registration, licensure or disciplinary status types (beginning with 1/1/78, when the board’s records were first automated). Entries are in reverse chronological order; new entries of each type supersede the previous entry of that same type. These records do not display status type. Should you have any questions, please contact our Customer Information Center at 512-305-7030 or verifcic@tmb.state.tx.us Status Code: AC Effective Date: 02/27/1983 Description: ACTIVE THE INFORMATION IN THIS BOX WAS REPORTED BY THE LICENSEE AND HAS NOT BEEN VERIFIED BY THE TEXAS MEDICAL BOARD Gender: FEMALE Current Primary Practice Address: NW HILLS SURGICAL HOSPITAL 6818 AUSTIN CENTER BLVD AUSTIN , TX 78731 Years of Active Practice in the U.S. or Canada: The physician reports that he/she has actively practiced medicine in the United States or Canada for 26 year(s). Years of Active Practice in Texas: The physician reports that, of the above years he/she has actively practiced in the State of Texas for 25 year(s). Specialty Board Certification The physician reports that he/she holds the following specialty certifications issued by a board that is a member of the American Board of Medical Specialties or the Bureau of Osteopathic Specialists: Specialty Certification: AMERICAN OSTEO. BOARD OF NM/INVITRO Date: 2010 Primary Specialty The physician reports his/her primary practice is in the area of EMERGENCY MEDICINE. Secondary Specialty The physician did not report a secondary practice area. Name, Location and Graduation Date of All Medical Schools Attended Name: U. OF TEXAS MEDICAL SCHOOL AT SAN AN Location: SAN ANTONIO TX Graduation Date: 1982 Graduate Medical Education In The United States Or Canada Program Name: ROANOKE MEMORIAL Location: ROANOKE, VA Begin Date: 07/1982 Type: INTERNSHIP End Date: 07/1983 Specialty: ROTATING INTERNSHIP Hospital Privileges The physician reports that he/she has hospital privileges in the following in the State of Texas: Hospital: NW HILLS SURGICAL Location: AUSTIN Hospital: AUSTIN SURGICAL HOSP Location: AUSTIN Utilization Review The physician did not report whether he/she provides utilization review. NONE REPORTED Patient Services Accessibility: The physician reports that the patient service area is accessible to persons with disabilities as defined by federal law. Language Translation Services: The physician did not report whether he/she provided any language translation services for patients. Medicaid Participant: The physician reports that he/she does participate in the Medicaid program. Awards, Honors, Publications and Academic Appointments Optional Information The physician may optionally report descriptions of up to five such honors and has reported the following: NONE Malpractice Information Section 154.006(b)(16) of the Act requires that: a physician profile display a description of any medical malpractice claim against the physician, not including a description of any offers by the physician to settle the claim, for which the physician was found liable, a jury awarded monetary damages to the claimant, and the award has been determined to be final and not subject to further appeal. The physician has the following reportable claims. Description: NONE Criminal History Self-Reported Criminal Offenses:The physician is required to report a description of (1) "any conviction for an offense constituting a felony, a Class A or Class B misdemeanor, or a Class C misdemeanor involving moral turpitude" and (2) "any charges reported to the board to which the physician has pleaded no contest, for which the physician is the subject of deferred adjudication or pretrial diversion, or in which sufficient facts of guilt were found and the matter was continued by a court of competent jurisdiction." The physician has reported the following: Description: NONE Criminal history information is also obtained by TMB from the Texas Department of Public Safety. Resulting action, if any, will be reported under the TMB Action and Non-Disciplinary Restrictions section above. Disciplinary Actions By Other State Medical Boards The physician has reported the following: Description: NONE Physician Assistant Supervision To obtain primary source verifications, click name Description: NONE Advanced Practice Nurse Delegation To obtain primary source verifications, click name Description: NONE Summary of all License/Permit Types Issue Date: Type: 02/27/1983 LICENSED PHYSICIAN