Healthcare Provider Details

I. General information

NPI: 1477768752
Provider Name (Legal Business Name): BEVERLY GRAYCE REED M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 02/14/2023
Certification Date: 02/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5288 TOWNE SQUARE DRIVE
PLANO TX
75024
US

IV. Provider business mailing address

5288 TOWNE SQUARE DRIVE
PLANO TX
75024
US

V. Phone/Fax

Practice location:
  • Phone: 469-443-4329
  • Fax: 469-613-2266
Mailing address:
  • Phone: 469-443-4329
  • Fax: 469-613-2266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberQ0159
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number0165040A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: