Provider Demographics
NPI:1437520111
Name:REED, DEBREKA (FNP)
Entity Type:Individual
Prefix:
First Name:DEBREKA
Middle Name:
Last Name:REED
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14423 LAZY WILLOW CT
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77489-1858
Mailing Address - Country:US
Mailing Address - Phone:713-259-3598
Mailing Address - Fax:
Practice Address - Street 1:2600 FM 1764 RD STE 190
Practice Address - Street 2:
Practice Address - City:LA MARQUE
Practice Address - State:TX
Practice Address - Zip Code:77568-2826
Practice Address - Country:US
Practice Address - Phone:281-886-8964
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-07
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP129165363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily