Rediclinic of MD, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

REDICLINIC OF MD, LLC

Practice address

9300 Lakeside Blvd
Owings Mills, MD 21117-4953

Phone

(713) 335-1754

NPI assigned

Oct 3, 2014

Organization subpart

No

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

Authorized official

Name

Danielle Barrera

Title

Chief Operating Officer

Phone

(713) 580-9489

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1412294400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1412294400000",
    "number": "1972906022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 GREENWAY PLZ",
            "address_2": "STE. 2950",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770460905",
            "telephone_number": "713-335-1754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9300 LAKESIDE BLVD",
            "city": "OWINGS MILLS",
            "state": "MD",
            "postal_code": "211174953",
            "telephone_number": "713-335-1754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDICLINIC OF MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-03",
        "last_updated": "2014-10-03",
        "status": "A",
        "authorized_official_last_name": "BARRERA",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "713-580-9489"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Owings Mills, MD
• Providers in Owings Mills, MD by specialty
• Clinic/Center in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; 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.