Provider Demographics
NPI:1467672782
Name:BROOKS REED, DAPHNE L (DMD)
Entity Type:Individual
Prefix:DR
First Name:DAPHNE
Middle Name:L
Last Name:BROOKS REED
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2101 CRAWFORD ST
Mailing Address - Street 2:SUITE #204
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002
Mailing Address - Country:US
Mailing Address - Phone:713-757-1948
Mailing Address - Fax:713-757-9835
Practice Address - Street 1:2101 CRAWFORD ST
Practice Address - Street 2:SUITE #204
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77002
Practice Address - Country:US
Practice Address - Phone:713-757-1948
Practice Address - Fax:713-757-9835
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX134421223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
737261OtherUNITED CONCORDIA
82D112OtherBC BS