Provider Demographics
NPI:1437501160
Name:REED, ALEXIA-RAE DE-HARA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALEXIA-RAE
Middle Name:DE-HARA
Last Name:REED
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 HOWARD ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78212-5522
Mailing Address - Country:US
Mailing Address - Phone:337-692-2269
Mailing Address - Fax:
Practice Address - Street 1:105 HOWARD ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-5522
Practice Address - Country:US
Practice Address - Phone:210-223-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1274726225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist