Provider Demographics
NPI:1750488714
Name:REID, TRUMAN GLEN (MA MSW PAP LPC)
Entity Type:Individual
Prefix:DR
First Name:TRUMAN
Middle Name:GLEN
Last Name:REID
Suffix:
Gender:M
Credentials:MA MSW PAP LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:113 N SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-3924
Mailing Address - Country:US
Mailing Address - Phone:817-447-0088
Mailing Address - Fax:817-295-2517
Practice Address - Street 1:113 N SCOTT ST
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-3924
Practice Address - Country:US
Practice Address - Phone:817-447-0088
Practice Address - Fax:817-295-2517
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6603101YP2500X
TX2706104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2002693OtherCIGNA BEHAVIORAL HEALTH
TX7661109OtherAETNA
TX272109OtherVALUE OPTIONS
TX82112LOtherBCBS