MEDICARE: MARCUS WAYNE REED PA-C

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	363AM0700X	Medical Physician Assistant	PA02941	TX

General Provider Information

NPI Number	:	1801810957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCUS WAYNE REED PA-C

Provider Business Mailing Address
First Line	:	2631 WELLS CT
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-6943
Country	:	US
Telephone Number	:	972-293-6675
Fax Number	:

Provider Business Practice Location Address
First Line	:	7441 MARVIN D LOVE FWY STE 300
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75237-3770
Country	:	US
Telephone Number	:	972-572-1998
Fax Number	:	972-572-4842

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/26/2006
Last Update Date	:	06/11/2010

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