Provider Demographics
NPI:1518226802
Name:REED, CARLA DENISE (RNFA)
Entity Type:Individual
Prefix:
First Name:CARLA
Middle Name:DENISE
Last Name:REED
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1315 PILOT LN
Mailing Address - Street 2:
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77554-9347
Mailing Address - Country:US
Mailing Address - Phone:936-671-3106
Mailing Address - Fax:
Practice Address - Street 1:21638 TOMBALL PKWY STE E
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1891
Practice Address - Country:US
Practice Address - Phone:281-251-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-08
Last Update Date:2014-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX614635363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
RN LIC 614635OtherRNFA