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General NPI Number Information
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NPI Number | 1578926390
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Entity Type | Organization
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Legal Business Name | REAGAN REID ENTERPRISE INC
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Dates
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Enumeration Date | 03/30/2016
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Last Update Date | 03/21/2025
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Provider Practice Location Address
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Address Line | 7453 LAS COLINAS BLVD
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City | IRVING
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State | TX
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Zip | 75063-7561
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Country | US
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Telephone | 972-215-6934
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Fax | 972-607-9254
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Provider Business Mailing Address
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Address Line | 7453 LAS COLINAS BLVD
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City | IRVING
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State | TX
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Zip | 75063-7561
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Country | US
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Telephone | 972-215-6934
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Fax | 972-607-9254
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. TRACI L SANTANGELO
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Credential |
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Telephone | 972-215-6934
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | AP124122
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License Number State | TX
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