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General NPI Number Information
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NPI Number | 1306242888
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Entity Type | Organization
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Legal Business Name | DUSTIN L. REID MD PA
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Dates
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Enumeration Date | 11/12/2014
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Last Update Date | 11/12/2014
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Provider Practice Location Address
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Address Line | 901 W 38TH ST STE 405
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City | AUSTIN
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State | TX
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Zip | 78705-1162
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Country | US
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Telephone | 512-420-8813
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Fax |
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Provider Business Mailing Address
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Address Line | 901 W 38TH ST STE 405
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City | AUSTIN
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State | TX
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Zip | 78705-1162
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Country | US
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Telephone | 512-420-8813
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DUSTIN REID
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Credential | MD
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Telephone | 512-420-8803
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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 |
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License Number State |
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