Provider Demographics
NPI:1841438348
Name:REDICLINIC HOLDINGS LLC
Entity type:Organization
Organization Name:REDICLINIC HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:P
Authorized Official - Last Name:FOURNET
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-580-9468
Mailing Address - Street 1:9 GREENWAY PLZ
Mailing Address - Street 2:SUITE 2950
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77046-0905
Mailing Address - Country:US
Mailing Address - Phone:713-935-0333
Mailing Address - Fax:713-358-4801
Practice Address - Street 1:9 GREENWAY PLZ
Practice Address - Street 2:SUITE 2950
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77046-0905
Practice Address - Country:US
Practice Address - Phone:713-935-0333
Practice Address - Fax:713-358-4801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty