Provider Demographics
NPI:1568232627
Name:RSMOD PLLC
Entity Type:Organization
Organization Name:RSMOD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAMILLE
Authorized Official - Middle Name:C
Authorized Official - Last Name:REAGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:972-503-7272
Mailing Address - Street 1:13396 PRESTON RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-5208
Mailing Address - Country:US
Mailing Address - Phone:972-503-7272
Mailing Address - Fax:972-851-7950
Practice Address - Street 1:13396 PRESTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-5208
Practice Address - Country:US
Practice Address - Phone:972-503-7272
Practice Address - Fax:972-851-7950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
No111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty