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NPI Code Detail

MEDICARE: MS. MICHELLE RENEE REDDICK PA-C

MEDICARE:  MS. MICHELLE RENEE REDDICK  PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA02427TX

General Provider Information

NPI Number : 1760436406
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MICHELLE RENEE REDDICK PA-C
Provider Business Mailing Address
First Line : 4410 CAPTAINS CT
Second Line :
City : MISSOURI CITY
State : TX
Zip : 77459-4288
Country : US
Telephone Number : 281-415-4245
Fax Number :
Provider Business Practice Location Address
First Line : 5749 SAN FELIPE ST
Second Line :
City : HOUSTON
State : TX
Zip : 77057-3101
Country : US
Telephone Number : 281-783-8162
Fax Number : 281-895-3083
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 11/16/2023

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Directions to “ MS. MICHELLE RENEE REDDICK PA-C” Practice Location

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