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General NPI Number Information
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NPI Number | 1679749055
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Entity Type | Organization
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Legal Business Name | THOMAS P REIS OD PS INC
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Dates
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Enumeration Date | 05/05/2008
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Last Update Date | 04/06/2015
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Provider Practice Location Address
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Address Line | 811 GEORGIANA ST
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City | PORT ANGELES
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State | WA
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Zip | 98362-3511
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Country | US
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Telephone | 360-417-2020
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Fax | 360-417-0254
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Provider Business Mailing Address
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Address Line | 811 GEORGIANA ST
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City | PORT ANGELES
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State | WA
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Zip | 98362-3511
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Country | US
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Telephone | 360-417-2020
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Fax | 360-417-0254
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Authorized Official
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Title or Position | OWNER
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Name | DR. THOMAS P. REIS
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Credential | O.D.
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Telephone | 360-417-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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