Provider Demographics
NPI:1649013434
Name:REEDER, BRADY JAMES (DC)
Entity type:Individual
Prefix:
First Name:BRADY
Middle Name:JAMES
Last Name:REEDER
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 1:5310 HARVEST HILL RD STE 135
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-5845
Mailing Address - Country:US
Mailing Address - Phone:214-902-0092
Mailing Address - Fax:
Practice Address - Street 1:5310 HARVEST HILL RD STE 135
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-5845
Practice Address - Country:US
Practice Address - Phone:214-902-0092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15946111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor