Provider Demographics
NPI:1972748036
Name:RED HEALTHCARE LLC
Entity Type:Organization
Organization Name:RED HEALTHCARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHAILENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHUKLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-812-9331
Mailing Address - Street 1:2815 W T C JESTER BLVD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77018-7064
Mailing Address - Country:US
Mailing Address - Phone:713-812-9331
Mailing Address - Fax:713-812-9337
Practice Address - Street 1:2815 W T C JESTER BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77018-7064
Practice Address - Country:US
Practice Address - Phone:713-812-9331
Practice Address - Fax:713-812-9337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-03
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX202887001Medicaid
0A3733Medicare PIN