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General NPI Number Information
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NPI Number | 1790668796
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Entity Type | Organization
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Legal Business Name | REDMED MANAGEMENT LLC
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Dates
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Enumeration Date | 07/28/2025
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 14665 W LISBON RD STE 1A
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City | BROOKFIELD
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State | WI
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Zip | 53005-1689
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Country | US
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Telephone | 872-325-3100
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Fax |
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Provider Business Mailing Address
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Address Line | 9900 WESTPARK DR STE 226
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City | HOUSTON
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State | TX
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Zip | 77063-5286
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Country | US
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Telephone | 872-325-3100
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | RAHUL GAJJALA
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Credential |
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Telephone | 872-325-3100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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