Provider Demographics
NPI:1497229298
Name:BACKMAN, REECE ANDREW
Entity Type:Individual
Prefix:
First Name:REECE
Middle Name:ANDREW
Last Name:BACKMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:849 COLISEUM WAY
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79601
Mailing Address - Country:US
Mailing Address - Phone:325-674-2328
Mailing Address - Fax:
Practice Address - Street 1:849 COLISEUM WAY
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601
Practice Address - Country:US
Practice Address - Phone:325-674-2328
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer