Healthcare Provider Details

I. General information

NPI: 1356255293
Provider Name (Legal Business Name): R2C2 TX MEDICAL PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/29/2026
Last Update Date: 09/29/2026
Certification Date: 09/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10601 CLARENCE DR STE 250
FRISCO TX
75033-3867
US

IV. Provider business mailing address

10601 CLARENCE DR STE 250
FRISCO TX
75033-3867
US

V. Phone/Fax

Practice location:
  • Phone: 337-315-7927
  • Fax:
Mailing address:
  • Phone: 337-315-7927
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number StateNULL

VIII. Authorized Official

Name: JONATHAN HODOR
Title or Position: OWNER
Credential: DO
Phone: 337-315-7927