Provider Demographics
NPI:1750459418
Name:REDICLINIC LLC
Entity Type:Organization
Organization Name:REDICLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:FOURNET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-580-9468
Mailing Address - Street 1:9 GREENWAY PLZ
Mailing Address - Street 2:SUITE 2950
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-0905
Mailing Address - Country:US
Mailing Address - Phone:713-580-9468
Mailing Address - Fax:713-935-9353
Practice Address - Street 1:3111 WOODRIDGE DR
Practice Address - Street 2:SUITE 500
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77087-2558
Practice Address - Country:US
Practice Address - Phone:713-935-0333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-01
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center