Provider Demographics
NPI:1336295617
Name:REEVES, CAROLYN BYRD (DDS)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:BYRD
Last Name:REEVES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2725 SAINT PAUL RD
Mailing Address - Street 2:
Mailing Address - City:VENUS
Mailing Address - State:TX
Mailing Address - Zip Code:76084-3516
Mailing Address - Country:US
Mailing Address - Phone:817-477-0601
Mailing Address - Fax:
Practice Address - Street 1:2725 SAINT PAUL RD
Practice Address - Street 2:
Practice Address - City:VENUS
Practice Address - State:TX
Practice Address - Zip Code:76084-3516
Practice Address - Country:US
Practice Address - Phone:817-477-0601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0014730122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist