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General NPI Number Information
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NPI Number | 1477675254
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Entity Type | Organization
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Legal Business Name | DUSTIN L. REID, MD PA
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Dates
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Enumeration Date | 04/04/2007
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Last Update Date | 01/25/2010
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Provider Practice Location Address
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Address Line | 901 W. 38TH ST., SUITE 401
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City | AUSTIN
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State | TX
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Zip | 78705-1162
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Country | US
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Telephone | 512-371-8817
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Fax | 512-371-8819
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Provider Business Mailing Address
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Address Line | 901 W. 38TH ST. SUITE 401
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City | AUSTIN
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State | TX
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Zip | 78705-1162
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Country | US
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Telephone | 512-371-8817
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Fax | 512-371-8819
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Authorized Official
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Title or Position | OWNER
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Name | DR. DUSTIN L REID
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Credential | MD
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Telephone | 512-371-8817
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | M1314
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number | M1314
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License Number State | TX
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