Active NPI
Max Edward Reddick, M.D.
- Dermatology Physician
- Houston, TX
National Provider Identifier
1922080613
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- E0589
- Practice address
- 902 Frostwood Dr
# 247
Houston, TX 77024-2420 - Phone
- (713) 465-2549
- Fax
- (713) 465-2444
- NPI assigned
- Nov 17, 2005
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | E0589 | TX | Primary |
Addresses
Primary practice location
902 Frostwood Dr
# 247
Houston, TX 77024-2420
Mailing address
902 Frostwood Dr
# 247
Houston, TX 77024-2420
Phone (713) 465-2549
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E0589 | TX | MD | Dermatology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132185600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1265155200000",
"number": "1922080613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "902 FROSTWOOD DR",
"address_2": "# 247",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770242420",
"telephone_number": "713-465-2549",
"fax_number": "713-465-2444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "902 FROSTWOOD DR",
"address_2": "# 247",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770242420",
"telephone_number": "713-465-2549",
"fax_number": "713-465-2444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDDICK",
"first_name": "MAX",
"middle_name": "EDWARD",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-11-17",
"last_updated": "2010-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "TX",
"license": "E0589",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.