Provider Demographics
NPI:1477310399
Name:REEVES, ANGELIQUE L
Entity Type:Individual
Prefix:
First Name:ANGELIQUE
Middle Name:L
Last Name:REEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 PLEASANT VALLEY LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76015-3545
Mailing Address - Country:US
Mailing Address - Phone:469-657-4493
Mailing Address - Fax:
Practice Address - Street 1:3400 PLEASANT VALLEY LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76015-3545
Practice Address - Country:US
Practice Address - Phone:469-657-4493
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-06
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker