Provider Demographics
NPI:1760688956
Name:REEVES CHIROPRACTIC
Entity Type:Organization
Organization Name:REEVES CHIROPRACTIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VICKY
Authorized Official - Middle Name:
Authorized Official - Last Name:DEAVER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:325-372-4062
Mailing Address - Street 1:2005 W WALLACE ST STE 7
Mailing Address - Street 2:
Mailing Address - City:SAN SABA
Mailing Address - State:TX
Mailing Address - Zip Code:76877-3950
Mailing Address - Country:US
Mailing Address - Phone:325-372-4062
Mailing Address - Fax:325-372-6086
Practice Address - Street 1:2005 W WALLACE ST STE 7
Practice Address - Street 2:
Practice Address - City:SAN SABA
Practice Address - State:TX
Practice Address - Zip Code:76877-3950
Practice Address - Country:US
Practice Address - Phone:325-372-4062
Practice Address - Fax:325-372-6086
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX8589111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX609400Medicare ID - Type Unspecified
TX0042ERMedicare UPIN