NPIMap

Organization Active NPI

Red Oak Physical Medicine Clinic PLLC

  • Chiropractor
  • Red Oak, TX
National Provider Identifier
1649494261
Registry record updated Jun 21, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
RED OAK PHYSICAL MEDICINE CLINIC PLLC
Practice address
307 E Ovilla Rd
Suite 100
Red Oak, TX 75154-3833
Phone
(972) 576-5501
Fax
(972) 576-5654
NPI assigned
Apr 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2017

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

Authorized official

Name
Dr. Brenda Ross, D.C.
Title
Owner
Phone
(972) 576-5501

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 111N00000X Primary

Addresses

Primary practice location

307 E Ovilla Rd
Suite 100
Red Oak, TX 75154-3833

Mailing address

307 E Ovilla Rd
Suite 100
Red Oak, TX 75154-3833
Phone (972) 576-5501

Other identifiers 4

IdentifierTypeStateIssuer
1477544963OtherTXBCBS - ZUBER - NPI
1881873339OtherTXDR. BRENDA - NPI
1255362554OtherTXBCBS - HOLLANDER NPI
0077PGOtherTXBCBS GROUP #

Other names 1

  • Red Oak Chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

307 E Ovilla Rd
Ste 100
Red Oak, TX 75154
Phone (972) 576-5501

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498003200000",
    "number": "1649494261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "307 E OVILLA RD",
            "address_2": "SUITE 100",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "751543833",
            "telephone_number": "972-576-5501",
            "fax_number": "972-576-5654"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "307 E OVILLA RD",
            "address_2": "SUITE 100",
            "city": "RED OAK",
            "state": "TX",
            "postal_code": "751543833",
            "telephone_number": "972-576-5501",
            "fax_number": "972-576-5654"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED OAK PHYSICAL MEDICINE CLINIC PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-13",
        "last_updated": "2017-06-21",
        "status": "A",
        "authorized_official_last_name": "ROSS",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "972-576-5501",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - ZUBER - NPI",
            "identifier": "1477544963",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DR. BRENDA - NPI",
            "identifier": "1881873339",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - HOLLANDER NPI",
            "identifier": "1255362554",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP #",
            "identifier": "0077PG",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Oak Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Red Oak, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2017; 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.