Provider Demographics
NPI:1467696963
Name:REED, LUCKEY CONNOR (MD)
Entity Type:Individual
Prefix:
First Name:LUCKEY
Middle Name:CONNOR
Last Name:REED
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 RIDGEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78628-8366
Mailing Address - Country:US
Mailing Address - Phone:832-798-3186
Mailing Address - Fax:
Practice Address - Street 1:1617 N CALIFORNIA ST STE 2D
Practice Address - Street 2:
Practice Address - City:STOCKTON
Practice Address - State:CA
Practice Address - Zip Code:95204-6117
Practice Address - Country:US
Practice Address - Phone:209-933-9888
Practice Address - Fax:209-933-9988
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR4891207VM0101X
TXBP1-0034783207V00000X
CAC175206207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology