Provider Demographics
NPI:1265443121
Name:REEVES, BILL (MD)
Entity Type:Individual
Prefix:
First Name:BILL
Middle Name:
Last Name:REEVES
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 1:1704 S BLUE BELL RD
Mailing Address - Street 2:
Mailing Address - City:BRENHAM
Mailing Address - State:TX
Mailing Address - Zip Code:77833-5132
Mailing Address - Country:US
Mailing Address - Phone:979-836-6160
Mailing Address - Fax:
Practice Address - Street 1:1704 S BLUE BELL RD
Practice Address - Street 2:
Practice Address - City:BRENHAM
Practice Address - State:TX
Practice Address - Zip Code:77833-5132
Practice Address - Country:US
Practice Address - Phone:979-836-6160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX091101223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics