Provider Demographics
NPI:1205034766
Name:VINEY, REAGAN D'LYNN (MD)
Entity Type:Individual
Prefix:
First Name:REAGAN
Middle Name:D'LYNN
Last Name:VINEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3917 BAYBROOK CT
Mailing Address - Street 2:OB: OBSTETRICS & GYNECOLOGY
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79707-1431
Mailing Address - Country:US
Mailing Address - Phone:804-828-8614
Mailing Address - Fax:804-827-1229
Practice Address - Street 1:2500 W ILLINOIS AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701-6339
Practice Address - Country:US
Practice Address - Phone:432-699-2370
Practice Address - Fax:432-697-3524
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXN8870207VX0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyObstetrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB140780Medicare UPIN