Provider Demographics
NPI:1932105459
Name:REAVES, CAREN C (MD)
Entity Type:Individual
Prefix:
First Name:CAREN
Middle Name:C
Last Name:REAVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 S MAYHILL RD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76208-5910
Mailing Address - Country:US
Mailing Address - Phone:940-591-6700
Mailing Address - Fax:940-320-1220
Practice Address - Street 1:4370 MEDICAL ARTS DR STE 300
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1724
Practice Address - Country:US
Practice Address - Phone:940-591-6700
Practice Address - Fax:940-320-1220
Is Sole Proprietor?:No
Enumeration Date:2005-06-21
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK5494207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143362503Medicaid
TX143362502Medicaid
TX143362502Medicaid
H34378Medicare UPIN