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General NPI Number Information
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NPI Number | 1659997229
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Entity Type | Organization
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Legal Business Name | REDWOOD FAMILY HEALTH CENTER PA
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Dates
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Enumeration Date | 06/19/2020
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Last Update Date | 10/25/2020
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Provider Practice Location Address
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Address Line | 5971 VIRGINIA PKWY STE 100
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City | MCKINNEY
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State | TX
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Zip | 75071-5618
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Country | US
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Telephone | 972-791-8301
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Fax | 469-678-7312
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Provider Business Mailing Address
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Address Line | 5971 VIRGINIA PKWY STE 100
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City | MCKINNEY
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State | TX
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Zip | 75071-5618
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Country | US
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Telephone | 972-791-8301
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING ASSISTANT
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Name | MS. CLAUDIA PALENCIA
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Credential |
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Telephone | 847-410-5705
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | NULL
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