=====================================================
General NPI Number Information
=====================================================
NPI Number | 1205516135
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DAMIAN REED
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2023
-----------------------------------------------------
Last Update Date | 10/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7970 W JEFFERSON BLVD
-----------------------------------------------------
City | FORT WAYNE
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46804-4140
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 260-435-7001
-----------------------------------------------------
Fax | 512-628-3314
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1776 WOODSTEAD CT STE 208
-----------------------------------------------------
City | THE WOODLANDS
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77380-1480
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax | 512-628-3314
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LA2100X
-----------------------------------------------------
Taxonomy Name | Acute Care Nurse Practitioner
-----------------------------------------------------
License Number | 28278322A
-----------------------------------------------------
License Number State | IN
-----------------------------------------------------