Provider Demographics
NPI:1710964119
Name:UNIAT, REUBEN W (MD)
Entity Type:Individual
Prefix:DR
First Name:REUBEN
Middle Name:W
Last Name:UNIAT
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 1:907 EUREKA ST STE B
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76086-5880
Mailing Address - Country:US
Mailing Address - Phone:817-598-8150
Mailing Address - Fax:817-599-4902
Practice Address - Street 1:713 E ANDERSON ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086
Practice Address - Country:US
Practice Address - Phone:682-582-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-27
Last Update Date:2018-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF7651207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX120297005Medicaid
TX120297006Medicaid
TX8A1733OtherBCBS
TX120297001Medicaid
TX050075736OtherRAILROAD
TX050075736OtherRAILROAD
TX8A1733OtherBCBS
C22876Medicare UPIN
TX8B4814Medicare PIN