Redman Family Practice Clinic

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

D7266 Issued in TX

Legal business name

REDMAN FAMILY PRACTICE CLINIC

Practice address

107 N Winfree
Dayton, TX 77535

Phone

(936) 258-7664

Fax

(936) 258-9395

NPI assigned

May 24, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Paul Clark Redman I, M.D.

Title

Ceo

Phone

(936) 258-7664

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1213747200000",
    "number": "1740235118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 RANCHWOOD ST",
            "city": "DAYTON",
            "state": "TX",
            "postal_code": "775359212",
            "fax_number": "936-258-9395"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 N WINFREE",
            "city": "DAYTON",
            "state": "TX",
            "postal_code": "77535",
            "telephone_number": "936-258-7664",
            "fax_number": "936-258-9395"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDMAN FAMILY PRACTICE CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2008-06-18",
        "status": "A",
        "authorized_official_last_name": "REDMAN",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "CLARK",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "936-258-7664",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "D7266",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1824732-02",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1824732-01",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Tate Reed, LCDC
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• Charles L Rodgers, R.PH
• Anyse Maria Rodriguez, RBT

• Family Medicine Physician in Dayton, TX
• Providers in Dayton, TX by specialty
• Family Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.