Organization
REDRAIDERS ASSISTANTS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REKHA WAGLE (NPI ADMINISTRATOR)
(817) 756-8232
Entity
Organization
Contact information
Practice address
2901 4TH ST, LONGVIEW, TX 75605-5128
(817) 756-8236
Mailing address
510 E LOOP 281 STE B #624, LONGVIEW, TX 75605-5076
(817) 756-8232
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
01/11/2021
Last updated
01/25/2021
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