Provider Demographics
NPI:1760247449
Name:REEVES, ROATESS
Entity Type:Individual
Prefix:
First Name:ROATESS
Middle Name:
Last Name:REEVES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1322 VILLAGE GARDEN DR
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459-1513
Mailing Address - Country:US
Mailing Address - Phone:903-503-5305
Mailing Address - Fax:
Practice Address - Street 1:1322 VILLAGE GARDEN DR
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-1513
Practice Address - Country:US
Practice Address - Phone:903-503-5305
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-20
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No343800000XTransportation ServicesSecured Medical Transport (VAN)
No347E00000XTransportation ServicesTransportation Broker