NPIMap

Organization Active NPI

Rediclinic LLC

  • Clinic/Center
  • Owasso, OK
National Provider Identifier
1528107141
Registry record updated Jan 20, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
REDICLINIC LLC
Practice address
12101 E 96TH St N
Owasso, OK 74055-5320
Phone
(866) 935-0333
Fax
(713) 358-4801
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Eric Fournet
Title
Cfo
Phone
(713) 580-9468

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

12101 E 96TH St N
Owasso, OK 74055-5320

Mailing address

9 Greenway Plaza
Suite 2950
Houston, TX 77046-0905
Phone (866) 935-0333

Other identifiers 1

IdentifierTypeStateIssuer
600522427OtherOKPTAN

National Provider Directory

National Provider Directory

Locations

12101 E 96th St N
Owasso, OK 74055
Phone (918) 272-1134

Practitioners & affiliated clinicians

Practitioners 41

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 41

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232409600000",
    "number": "1528107141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 GREENWAY PLAZA",
            "address_2": "SUITE 2950",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460905",
            "telephone_number": "866-935-0333",
            "fax_number": "713-358-4801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12101 E 96TH ST N",
            "city": "OWASSO",
            "state": "OK",
            "postal_code": "740555320",
            "telephone_number": "866-935-0333",
            "fax_number": "713-358-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDICLINIC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2009-01-20",
        "status": "A",
        "authorized_official_last_name": "FOURNET",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "713-580-9468",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "600522427",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Owasso, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.