Basic Information
| Provider Information | |||||||||
| NPI: | 1114293701 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | REDOAK HOSPITAL | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6225 FM2920 | ||||||||
| Address2: | SUITE # 100 | ||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77379 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8323818299 | ||||||||
| FaxNumber: | 2816054563 | ||||||||
| Practice Location | |||||||||
| Address1: | 17440 REDOAK DR | ||||||||
| Address2: | |||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2812570404 | ||||||||
| FaxNumber: | 2816054563 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/28/2012 | ||||||||
| LastUpdateDate: | 02/12/2013 | ||||||||
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| AuthorizedOfficialLastName: | MOPARTY | ||||||||
| AuthorizedOfficialFirstName: | ROY | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 2812570404 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | B.E. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 100179 | TX | Y | Hospitals | General Acute Care Hospital |
No ID Information.