Provider Demographics
NPI:1699030338
Name:REED, LYSSA ARRAIS (DDS)
Entity Type:Individual
Prefix:
First Name:LYSSA
Middle Name:ARRAIS
Last Name:REED
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11010 W FM 471
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-4851
Mailing Address - Country:US
Mailing Address - Phone:210-688-9386
Mailing Address - Fax:
Practice Address - Street 1:11010 W FM 471
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-4851
Practice Address - Country:US
Practice Address - Phone:210-688-9386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-09
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX281501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice