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General NPI Number Information
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NPI Number | 1427058262
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Entity Type | Individual
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Provider Name | TERRY REYNOLDS O.D.
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Gender | Male
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Dates
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Enumeration Date | 07/22/2005
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Last Update Date | 02/21/2022
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Provider Practice Location Address
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Address Line | 7 12TH AVE NW
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City | ARAB
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State | AL
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Zip | 35016-1977
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Country | US
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Telephone | 256-586-4171
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 207243
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City | DALLAS
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State | TX
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Zip | 75320-7243
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Country | US
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Telephone | 636-200-4393
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Fax | 636-527-0766
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | S437-TA119
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License Number State | AL
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