Provider Demographics
NPI:1720431927
Name:REDOAK PSYCHIATRY
Entity Type:Organization
Organization Name:REDOAK PSYCHIATRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANN
Authorized Official - Middle Name:
Authorized Official - Last Name:VALERIO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-893-4111
Mailing Address - Street 1:17115 RED OAK DR STE 109
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090-2607
Mailing Address - Country:US
Mailing Address - Phone:281-893-4111
Mailing Address - Fax:281-397-8022
Practice Address - Street 1:17115 RED OAK DR STE 109
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2607
Practice Address - Country:US
Practice Address - Phone:281-893-4111
Practice Address - Fax:281-397-8022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX725093363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMA2340280OtherDEA