Provider Demographics
NPI:1669651501
Name:DEBRA K REID
Entity Type:Organization
Organization Name:DEBRA K REID
Other - Org Name:DEBRAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBRA
Authorized Official - Middle Name:KAY
Authorized Official - Last Name:REID
Authorized Official - Suffix:
Authorized Official - Credentials:LVN
Authorized Official - Phone:903-628-1360
Mailing Address - Street 1:103 NE FRONT ST
Mailing Address - Street 2:
Mailing Address - City:NEW BOSTON
Mailing Address - State:TX
Mailing Address - Zip Code:75570-2906
Mailing Address - Country:US
Mailing Address - Phone:903-628-1360
Mailing Address - Fax:
Practice Address - Street 1:103 NE FRONT ST
Practice Address - Street 2:
Practice Address - City:NEW BOSTON
Practice Address - State:TX
Practice Address - Zip Code:75570-2906
Practice Address - Country:US
Practice Address - Phone:903-628-1360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-28
Last Update Date:2008-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
TX119237335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX6085890001Medicare NSC