Healthcare Provider Details

I. General information

NPI: 1265013999
Provider Name (Legal Business Name): DARLA LORENE REED RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/15/2021
Last Update Date: 04/15/2021
Certification Date: 04/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10010 ROGERS XING STE 100
SAN ANTONIO TX
78251-4766
US

IV. Provider business mailing address

3551 ROGER BROOK DR ATTN: MCHE-ZDF-M
JBSA-FORT SAM HOUSTON TX
78234
US

V. Phone/Fax

Practice location:
  • Phone: 210-539-0941
  • Fax: 210-530-0203
Mailing address:
  • Phone: 210-539-0941
  • Fax: 210-539-0203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number675596
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number675596
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: