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General NPI Number Information
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NPI Number | 1467748558
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Entity Type | Individual
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Provider Name | DAVID ANDREW REYNOLDS D.O.
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Gender | Male
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Dates
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Enumeration Date | 06/27/2011
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 3551 ROGER BROOKE DR
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City | FORT SAM HOUSTON
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State | TX
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Zip | 78234
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Country | US
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Telephone | 210-916-3479
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Fax |
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Provider Business Mailing Address
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Address Line | WRAMC BLDG 2 RM 2G01 2900 GEORGIA AVE. NW
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City | WASHINGTON
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State | DC
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Zip | 20307-0001
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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 | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 0102203209
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0102203209
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License Number State | VA
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