Provider Demographics
NPI:1669816591
Name:MARK B. REEDY, M.D., PLLC
Entity Type:Organization
Organization Name:MARK B. REEDY, M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:B
Authorized Official - Last Name:REEDY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:325-692-4194
Mailing Address - Street 1:1665 ANTILLEY RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79606-5265
Mailing Address - Country:US
Mailing Address - Phone:325-692-4194
Mailing Address - Fax:
Practice Address - Street 1:1665 ANTILLEY RD
Practice Address - Street 2:SUITE 250
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79606-5265
Practice Address - Country:US
Practice Address - Phone:325-692-4194
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-22
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH8348207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic OncologyGroup - Multi-Specialty