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NPI Code Detail

MEDICARE: MS. NITA REAGON REED O.T.R.

MEDICARE: MS. NITA REAGON REED O.T.R.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational Therapist104311TX

General Provider Information

NPI Number : 1316141229
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. NITA REAGON REED O.T.R.
Provider Business Mailing Address
First Line : 2800 BILGLADE RD
Second Line :
City : FORT WORTH
State : TX
Zip : 76133-1616
Country : US
Telephone Number : 817-886-8976
Fax Number : 817-923-1263
Provider Business Practice Location Address
First Line : 901 PENNSYLVANIA AVE
Second Line :
City : FORT WORTH
State : TX
Zip : 76104-2226
Country : US
Telephone Number : 817-348-9711
Fax Number : 817-348-9809
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/13/2007
Last Update Date : 07/08/2007

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