Provider Demographics
NPI:1992429146
Name:REDLINE TEIP LLC
Entity type:Organization
Organization Name:REDLINE TEIP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:RADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-591-2256
Mailing Address - Street 1:940 S KIMBALL AVE STE 140
Mailing Address - Street 2:
Mailing Address - City:SOUTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76092-9023
Mailing Address - Country:US
Mailing Address - Phone:713-591-2256
Mailing Address - Fax:
Practice Address - Street 1:1120 EDEN RD STE 104
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-7915
Practice Address - Country:US
Practice Address - Phone:713-591-2256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-30
Last Update Date:2022-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy