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General NPI Number Information
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NPI Number | 1316193170
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Entity Type | Organization
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Legal Business Name | AUSTIN S. REEVES
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Dates
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Enumeration Date | 08/13/2008
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Last Update Date | 08/13/2008
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Provider Practice Location Address
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Address Line | 4110 MCKNIGHT RD
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City | TEXARKANA
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State | TX
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Zip | 75503-0921
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Country | US
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Telephone | 903-223-6000
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Fax | 903-223-6016
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Provider Business Mailing Address
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Address Line | 4110 MCKNIGHT RD
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City | TEXARKANA
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State | TX
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Zip | 75503-0921
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Country | US
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Telephone | 903-223-6000
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Fax | 903-223-6016
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Authorized Official
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Title or Position | PODIATRIST
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Name | AUSTIN S. REEVES
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Credential |
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Telephone | 903-223-6000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 178
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License Number State | AR
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