Provider Demographics
NPI:1346459484
Name:REA, KAREN FRAZER (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:FRAZER
Last Name:REA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:ESTELINE
Other - Last Name:FRAZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:907 WALNUT HILL DR
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75605-5054
Mailing Address - Country:US
Mailing Address - Phone:903-753-3531
Mailing Address - Fax:903-236-3514
Practice Address - Street 1:907 WALNUT HILL DR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75605-5054
Practice Address - Country:US
Practice Address - Phone:903-753-3531
Practice Address - Fax:903-236-3514
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXTX14753122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist