Provider Demographics
NPI:1275212276
Name:REFRAME HEALTHCARE MEDICAL GROUP
Entity Type:Organization
Organization Name:REFRAME HEALTHCARE MEDICAL GROUP
Other - Org Name:FRAME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BELL VAN DER WAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-906-3366
Mailing Address - Street 1:447 SUTTER ST STE 405
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94108-4618
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:12828 WILLOW CENTRE DR
Practice Address - Street 2:STE D #19
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77066-3043
Practice Address - Country:US
Practice Address - Phone:415-917-1886
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-17
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty