Provider Demographics
NPI:1013472448
Name:REDD MEDICAL PLLC
Entity Type:Organization
Organization Name:REDD MEDICAL PLLC
Other - Org Name:REDD HEALTHCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:REBECCA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:409-489-8938
Mailing Address - Street 1:PO BOX 2048
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:TX
Mailing Address - Zip Code:75951
Mailing Address - Country:US
Mailing Address - Phone:409-594-0255
Mailing Address - Fax:251-260-8205
Practice Address - Street 1:811 N MAIN ST
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:TX
Practice Address - Zip Code:75951
Practice Address - Country:US
Practice Address - Phone:409-489-8938
Practice Address - Fax:251-260-8205
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:REDD MEDICAL PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-02-11
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty