MEDICARE: DR. DAVID GLENN REYNOLDS SR. MD

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	207RN0300X	Nephrology Physician	H6541	TX
2	174400000X	Specialist	H6541	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
8	P00025103	OTHER	TX	RAILROAD MEDICARE
9	241430304	OTHER	OK	OKLAHOMA MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	00K55R	OTHER	TX	BLUE CROSS BLUE SHIELD
7	4333749	OTHER		AETNA

General Provider Information

NPI Number	:	1801894365
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID GLENN REYNOLDS SR. MD

Provider Business Mailing Address
First Line	:	2741 FM 691
Second Line	:
City	:	DENISON
State	:	TX
Zip	:	75020
Country	:	US
Telephone Number	:	903-893-7170
Fax Number	:	903-893-4372

Provider Business Practice Location Address
First Line	:	2741 FM 691
Second Line	:
City	:	DENISON
State	:	TX
Zip	:	75020
Country	:	US
Telephone Number	:	903-893-7170
Fax Number	:	903-893-4372

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

Provider Enumeration Date	:	07/08/2005
Last Update Date	:	01/13/2026

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