Provider Demographics
NPI:1225118524
Name:REESE, MERRICK HOGAN (MD)
Entity Type:Individual
Prefix:DR
First Name:MERRICK
Middle Name:HOGAN
Last Name:REESE
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:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-8000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:12221 MERIT DR
Practice Address - Street 2:#500
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75251-2202
Practice Address - Country:US
Practice Address - Phone:972-490-2900
Practice Address - Fax:972-386-0261
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD1019207RX0202X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX139307620Medicaid
TX139307621Medicaid
TX139307619Medicaid
TX8R1534OtherBLUE CROSS OF TEXAS
TX110077952OtherRAILROAD
TX8R1534OtherBLUE CROSS OF TEXAS
TX139307621Medicaid
TXTXB109782Medicare PIN
TX139307611OtherCSHCN
TX139307608Medicaid
TXTXB109784Medicare PIN
TX8039N3Medicare PIN
TX8R1534OtherBLUE CROSS OF TEXAS
TX823561Medicare PIN
TX8799M6Medicare PIN
TXTXB109782Medicare PIN
TX139307616Medicaid
TX8D7619Medicare PIN