Provider Demographics
NPI:1336575604
Name:JASON T. REDLER, D.C., P.A.
Entity Type:Organization
Organization Name:JASON T. REDLER, D.C., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JAN
Authorized Official - Middle Name:B
Authorized Official - Last Name:RUGG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-892-3707
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-18
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty