Provider Demographics
NPI:1841038023
Name:RECOVERY MEDICINE, PLLC
Entity type:Organization
Organization Name:RECOVERY MEDICINE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MCQUEEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-201-0880
Mailing Address - Street 1:PO BOX 34
Mailing Address - Street 2:
Mailing Address - City:INGRAM
Mailing Address - State:TX
Mailing Address - Zip Code:78025-0034
Mailing Address - Country:US
Mailing Address - Phone:830-201-0880
Mailing Address - Fax:830-323-0127
Practice Address - Street 1:3300 JUNCTION HWY
Practice Address - Street 2:
Practice Address - City:INGRAM
Practice Address - State:TX
Practice Address - Zip Code:78025-3267
Practice Address - Country:US
Practice Address - Phone:830-201-0880
Practice Address - Fax:830-323-0127
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center