Provider Demographics
NPI:1861815342
Name:OCHOA, REESE (DC)
Entity Type:Individual
Prefix:DR
First Name:REESE
Middle Name:
Last Name:OCHOA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 BLUE HERON DR STE B
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77316
Mailing Address - Country:US
Mailing Address - Phone:936-582-0404
Mailing Address - Fax:936-582-0410
Practice Address - Street 1:125 BLUE HERON DR STE B
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77316
Practice Address - Country:US
Practice Address - Phone:936-582-0404
Practice Address - Fax:936-582-0410
Is Sole Proprietor?:No
Enumeration Date:2014-02-04
Last Update Date:2017-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX12526111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor