Provider Demographics
NPI:1447395603
Name:REEVES MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:REEVES MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:HR DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NADINE
Authorized Official - Middle Name:C
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:432-447-3551
Mailing Address - Street 1:880 W DAGGETT ST STE 2
Mailing Address - Street 2:
Mailing Address - City:PECOS
Mailing Address - State:TX
Mailing Address - Zip Code:79772-6914
Mailing Address - Country:US
Mailing Address - Phone:432-447-0077
Mailing Address - Fax:432-447-0222
Practice Address - Street 1:2323 TEXAS ST
Practice Address - Street 2:
Practice Address - City:PECOS
Practice Address - State:TX
Practice Address - Zip Code:79772-7338
Practice Address - Country:US
Practice Address - Phone:432-447-3551
Practice Address - Fax:432-447-5434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2010-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXCD8940OtherRAIL ROAD MEDICARE
TX27NPOtherBLUE CROSS BLUE SHIELD
TX145383902Medicaid
TX00419RMedicare ID - Type Unspecified