Healthcare Provider Details

I. General information

NPI: 1033564059
Provider Name (Legal Business Name): JASON T REDLER DC, RYAN ROBINSON DC, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/27/2016
Last Update Date: 04/27/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

817 TOWNE CT SUITE 100
SAGINAW TX
76179-1201
US

IV. Provider business mailing address

615 COMMERCE ST
FORT WORTH TX
76102-5450
US

V. Phone/Fax

Practice location:
  • Phone: 817-232-2240
  • Fax:
Mailing address:
  • Phone: 817-439-9890
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number10353
License Number StateTX

VIII. Authorized Official

Name: JASON REDLER
Title or Position: OWNER CHIROPRACTOR
Credential: D.C.
Phone: 817-439-9890