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General NPI Number Information
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NPI Number | 1356663694
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Entity Type | Individual
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Provider Name | AUDRA K. REID LPTA
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Gender | Female
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Dates
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Enumeration Date | 02/26/2010
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Last Update Date | 05/09/2019
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Provider Practice Location Address
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Address Line | 13915 MOPAC EXPRESSWAY
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City | AUSTIN
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State | TX
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Zip | 78728
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Country | US
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Telephone | 877-366-2580
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Fax |
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Provider Business Mailing Address
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Address Line | 9200 HOOD RD
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City | CHARLOTTE
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State | NC
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Zip | 28215-7713
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Country | US
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Telephone | 704-596-2414
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2057243
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 2978
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License Number State | NC
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