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NPI Code Detail

MEDICARE: JENNIFER BROOKE REID P.A.-C

MEDICARE: JENNIFER BROOKE REID P.A.-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
1363A00000XPhysician AssistantPA02322TX

General Provider Information

NPI Number : 1851374599
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER BROOKE REID P.A.-C
Provider Business Mailing Address
First Line : 10740 N GESSNER DR
Second Line : STE 310
City : HOUSTON
State : TX
Zip : 77064-1240
Country : US
Telephone Number : 281-897-0416
Fax Number : 281-890-8908
Provider Business Practice Location Address
First Line : 3201 PALMER HWY
Second Line :
City : TEXAS CITY
State : TX
Zip : 77590-6723
Country : US
Telephone Number : 409-945-4246
Fax Number : 409-945-4260
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2005
Last Update Date : 08/09/2021

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