Organization
REDICLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERIC FOURNET (CFO)
(713) 580-9468
Entity
Organization
Contact information
Practice address
12101 E 96TH ST N, OWASSO, OK 74055-5320
(866) 935-0333
(713) 358-4801
Mailing address
9 GREENWAY PLAZA, SUITE 2950, HOUSTON, TX 77046-0905
(866) 935-0333
(713) 358-4801
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
600522427
PTAN
OK
Enumeration date
02/06/2007
Last updated
01/20/2009
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