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General NPI Number Information
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NPI Number | 1093895757
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Entity Type | Organization
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Legal Business Name | PATRICK D REEVES MDPA
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Dates
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Enumeration Date | 10/17/2006
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Last Update Date | 06/30/2008
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Provider Practice Location Address
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Address Line | 4315 28TH STREET SUITE 2
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City | LUBBOCK
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State | TX
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Zip | 79410
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Country | US
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Telephone | 806-792-2104
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Fax | 806-792-2134
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Provider Business Mailing Address
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Address Line | 4315 28TH STREET SUITE 2
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City | LUBBOCK
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State | TX
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Zip | 79410
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Country | US
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Telephone | 806-792-2104
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Fax | 806-792-2134
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Authorized Official
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Title or Position | OWNER
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Name | MR. PATRICK DARREN REEVES
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Credential | MD
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Telephone | 806-792-2104
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number | 007928
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License Number State | TX
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