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General NPI Number Information
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NPI Number | 1417266495
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Entity Type | Individual
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Provider Name | DANA LYNN REAVES-O'NEAL CPNP
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Gender | Female
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Dates
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Enumeration Date | 09/24/2010
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Last Update Date | 07/08/2019
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Provider Practice Location Address
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Address Line | 6651 MAIN STREET SUITE MC-E 1690.41
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City | HOUSTON
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State | TX
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Zip | 77030-2351
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Country | US
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Telephone | 832-826-5942
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Fax | 832-825-9637
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Provider Business Mailing Address
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Address Line | 6651 MAIN ST # E1960.41
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City | HOUSTON
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State | TX
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Zip | 77030-2351
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Country | US
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Telephone | 832-826-5942
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 573344
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | AP119167
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License Number State | TX
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