Provider Demographics
NPI:1689870735
Name:REDDICK, CLAIRE SMITH (MD)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:SMITH
Last Name:REDDICK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9301 N CENTRAL EXPY STE 470
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0803
Mailing Address - Country:US
Mailing Address - Phone:214-506-1115
Mailing Address - Fax:214-435-6688
Practice Address - Street 1:9301 N CENTRAL EXPY STE 470
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0803
Practice Address - Country:US
Practice Address - Phone:214-506-1115
Practice Address - Fax:214-435-6688
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6608207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty