Organization
REALISTIC MEDICAL CLINIC, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LLOYD DAVID RANDALL (ADMINISTRATOR)
(713) 434-5877
Entity
Organization
Contact information
Practice address
2646 S LOOP W, SUITE 520, HOUSTON, TX 77054-2665
(713) 434-5877
(832) 834-7539
Mailing address
2646 SOUTH LOOP WEST, SUITE 520, HOUSTON, TX 77054
(713) 434-5877
(832) 834-7539
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/24/2014
Last updated
04/20/2015
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