Provider Demographics
NPI:1659484475
Name:O'REAR, REAGAN ELIZABETH (OD)
Entity Type:Individual
Prefix:
First Name:REAGAN
Middle Name:ELIZABETH
Last Name:O'REAR
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 N LOOP 336 W
Mailing Address - Street 2:STE B
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-3540
Mailing Address - Country:US
Mailing Address - Phone:936-539-2020
Mailing Address - Fax:936-756-7916
Practice Address - Street 1:1422 N LOOP 336 W
Practice Address - Street 2:STE B
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-3540
Practice Address - Country:US
Practice Address - Phone:936-539-2020
Practice Address - Fax:936-756-7916
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6460TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXVO8256Medicare UPIN
TX8F2376Medicare PIN