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General NPI Number Information
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NPI Number | 1306468616
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Entity Type | Individual
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Provider Name | ISAIAH REEVES
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Gender | Male
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 01/29/2025
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Provider Practice Location Address
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Address Line | 2240 GULF FWY S FL 4
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City | LEAGUE CITY
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State | TX
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Zip | 77573-5143
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Country | US
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Telephone | 832-505-1234
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Fax |
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Provider Business Mailing Address
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Address Line | 1290 HERCULES AVE
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City | HOUSTON
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State | TX
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Zip | 77058-2749
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2083A0100X
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Taxonomy Name | Aerospace Medicine Physician
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License Number | U2992
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | U2992
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License Number State | TX
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