Provider Demographics
NPI:1942305883
Name:REEVES, PATRICK DARREN (MD)
Entity Type:Individual
Prefix:MR
First Name:PATRICK
Middle Name:DARREN
Last Name:REEVES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4315 28TH ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410
Mailing Address - Country:US
Mailing Address - Phone:806-792-2104
Mailing Address - Fax:806-792-2134
Practice Address - Street 1:4315 28TH ST
Practice Address - Street 2:SUITE 2
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410
Practice Address - Country:US
Practice Address - Phone:806-792-2104
Practice Address - Fax:806-792-2134
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6263207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8H3780OtherBLUE CROSS
TX8A1687Medicare ID - Type Unspecified
TX8H3780OtherBLUE CROSS