MEDICARE: REGIONAL EMPLOYEE ASSISTANCE PROGRAM INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0079DU	OTHER	TX	BLUE CROSS

General Provider Information

NPI Number	:	1881656247
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REGIONAL EMPLOYEE ASSISTANCE PROGRAM INC

Provider Business Mailing Address
First Line	:	2403 N LAURENT ST
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77901-4119
Country	:	US
Telephone Number	:	979-696-0267
Fax Number	:

Provider Business Practice Location Address
First Line	:	1602 ROCK PRAIRIE RD
Second Line	:	STE. 1100
City	:	COLLEGE STATION
State	:	TX
Zip	:	77845-8306
Country	:	US
Telephone Number	:	979-693-2586
Fax Number	:	979-693-7327

Authorized Official
Title or Position	:	VP PHYSICIAN BUSINESS SERVICES
Name	:	JAMES P WRIGHT
Credential	:
Telephone Number	:	615-778-1502

Provider Enumeration Date	:	04/03/2006
Last Update Date	:	05/15/2019

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Directions to “REGIONAL EMPLOYEE ASSISTANCE PROGRAM INC ” Practice Location

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