Healthcare Provider Details

I. General information

NPI: 1447395603
Provider Name (Legal Business Name): REEVES MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 10/22/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 TEXAS ST
PECOS TX
79772-7338
US

IV. Provider business mailing address

880 W DAGGETT ST STE 2
PECOS TX
79772-6914
US

V. Phone/Fax

Practice location:
  • Phone: 432-447-3551
  • Fax: 432-447-5434
Mailing address:
  • Phone: 432-447-0077
  • Fax: 432-447-0222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: NADINE C SMITH
Title or Position: HR DIRECTOR
Credential:
Phone: 432-447-3551