Provider Demographics
NPI:1689669327
Name:REIMER, MARK BRENNAN (MD)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:BRENNAN
Last Name:REIMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 SW 25TH AVE
Mailing Address - Street 2:
Mailing Address - City:MINERAL WELLS
Mailing Address - State:TX
Mailing Address - Zip Code:76067-8246
Mailing Address - Country:US
Mailing Address - Phone:940-328-6404
Mailing Address - Fax:940-328-6523
Practice Address - Street 1:202 SW 25TH AVE
Practice Address - Street 2:SUITE 1000
Practice Address - City:MINERAL WELLS
Practice Address - State:TX
Practice Address - Zip Code:76067-8298
Practice Address - Country:US
Practice Address - Phone:940-328-6521
Practice Address - Fax:940-328-7501
Is Sole Proprietor?:No
Enumeration Date:2005-09-20
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH 1260207V00000X
MN49845207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology