MEDICARE: JENNA ROSE REESE

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
1	305R00000X	Preferred Provider Organization	12408	TX

General Provider Information

NPI Number	:	1770959165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JENNA ROSE REESE

Provider Business Mailing Address
First Line	:	2340 TEXAS HERITAGE PKWY STE 100
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-4635
Country	:	US
Telephone Number	:	832-913-8970
Fax Number	:	832-201-9629

Provider Business Practice Location Address
First Line	:	2340 TEXAS HERITAGE PKWY STE 100
Second Line	:
City	:	KATY
State	:	TX
Zip	:	77494-4635
Country	:	US
Telephone Number	:	832-913-8970
Fax Number	:	832-201-9629

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	DR. JENNA R REESE
Credential	:	DC
Telephone Number	:	832-913-8970

Provider Enumeration Date	:	08/19/2015
Last Update Date	:	04/14/2026

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