Provider Demographics
NPI:1174811368
Name:HEALTHCARE ONE ASSOCIATES PLLC
Entity type:Organization
Organization Name:HEALTHCARE ONE ASSOCIATES PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:C. BRAD
Authorized Official - Middle Name:
Authorized Official - Last Name:REDDEN
Authorized Official - Suffix:
Authorized Official - Credentials:APRN, CNP
Authorized Official - Phone:405-295-2900
Mailing Address - Street 1:1900 S COUNTRY CLUB RD
Mailing Address - Street 2:
Mailing Address - City:EL RENO
Mailing Address - State:OK
Mailing Address - Zip Code:73036-5427
Mailing Address - Country:US
Mailing Address - Phone:405-295-2900
Mailing Address - Fax:405-295-2905
Practice Address - Street 1:1900 S COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:EL RENO
Practice Address - State:OK
Practice Address - Zip Code:73036-5427
Practice Address - Country:US
Practice Address - Phone:405-295-2900
Practice Address - Fax:405-295-2905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-21
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK76189261QU0200X
261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200346240AMedicaid
OKOKAAA2519Medicare PIN