Provider Demographics
NPI:1760407845
Name:REDLER, JASON TODD (DC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:TODD
Last Name:REDLER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 TOWNE CT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAGINAW
Mailing Address - State:TX
Mailing Address - Zip Code:76179-1201
Mailing Address - Country:US
Mailing Address - Phone:817-232-2240
Mailing Address - Fax:817-232-2316
Practice Address - Street 1:817 TOWNE CT
Practice Address - Street 2:SUITE 100
Practice Address - City:SAGINAW
Practice Address - State:TX
Practice Address - Zip Code:76179-1201
Practice Address - Country:US
Practice Address - Phone:817-232-2240
Practice Address - Fax:817-232-2316
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2013-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10353111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor