Provider Demographics
NPI:1225018476
Name:REIMER, GREGORY L (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:L
Last Name:REIMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7226 BLACK FOREST DR
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-5973
Mailing Address - Country:US
Mailing Address - Phone:832-934-1024
Mailing Address - Fax:
Practice Address - Street 1:7226 BLACK FOREST DR
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-5973
Practice Address - Country:US
Practice Address - Phone:832-934-1024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-21
Last Update Date:2010-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF8300207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1225018476OtherTRICARE SOUTH
TX140229932Medicaid
TX88461ZOtherBCBSTX PROV NO
TX140229934Medicaid
TX140229933Medicaid
TX8509B6Medicare PIN
TX1225018476OtherTRICARE SOUTH
TX080187101Medicare PIN
TXF29576Medicare UPIN
TX140229933Medicaid
TX8685B9Medicare PIN
TX8013B7Medicare PIN
TX080187102Medicare PIN