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General NPI Number Information
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NPI Number | 1750513131
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Entity Type | Individual
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Provider Name | STEPHEN LARRY REID FNP
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Gender | Male
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 07/17/2013
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Provider Practice Location Address
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Address Line | 3128 SABA LN
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City | PORT NECHES
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State | TX
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Zip | 77651-5422
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Country | US
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Telephone | 409-724-1404
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 HICKORY
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City | NEDERLAND
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State | TX
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Zip | 77627-4782
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Country | US
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Telephone | 409-722-6789
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 642078
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License Number State | TX
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