Realistic Medical Clinic, LLC

Primary specialty

ContractorTaxonomy code 171W00000X

Legal business name

REALISTIC MEDICAL CLINIC, LLC

Practice address

2646 S Loop W
Suite 520
Houston, TX 77054-2665

Phone

(713) 434-5877

Fax

(832) 834-7539

NPI assigned

Jul 24, 2014

Last updated

Apr 20, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Lloyd David Randall

Title

Administrator

Phone

(713) 434-5877

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1406160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429488000000",
    "number": "1972911725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2646 SOUTH LOOP WEST",
            "address_2": "SUITE 520",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "77054",
            "telephone_number": "713-434-5877",
            "fax_number": "832-834-7539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2646 S LOOP W",
            "address_2": "SUITE 520",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770542665",
            "telephone_number": "713-434-5877",
            "fax_number": "832-834-7539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REALISTIC MEDICAL CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-24",
        "last_updated": "2015-04-20",
        "status": "A",
        "authorized_official_last_name": "RANDALL",
        "authorized_official_first_name": "LLOYD",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "713-434-5877"
    },
    "taxonomies": [
        {
            "code": "171W00000X",
            "taxonomy_group": "",
            "desc": "Contractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Contractor in Houston, TX
• Providers in Houston, TX by specialty
• Contractor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2015; 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.