Provider Demographics
NPI:1295618452
Name:PROSPECTIVE MEDICAL PLLC
Entity type:Organization
Organization Name:PROSPECTIVE MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:PATRICK
Authorized Official - Last Name:REDROW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:713-482-1208
Mailing Address - Street 1:14053 MEMORIAL DR STE 454
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77079-6826
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2020 NASA PKWY STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77058-3697
Practice Address - Country:US
Practice Address - Phone:713-482-1208
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-28
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center