MEDICARE: LAUREN HARKER REID

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	363L00000X	Nurse Practitioner	AP146138	TX

General Provider Information

NPI Number	:	1871248633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LAUREN HARKER REID

Provider Business Mailing Address
First Line	:	7314 CASA LOMA AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75214-4105
Country	:	US
Telephone Number	:	317-760-1054
Fax Number	:

Provider Business Practice Location Address
First Line	:	7314 CASA LOMA AVE
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75214-4105
Country	:	US
Telephone Number	:	317-760-1054
Fax Number	:

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

Provider Enumeration Date	:	02/19/2022
Last Update Date	:	02/19/2022

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Directions to “ LAUREN HARKER REID ” Practice Location

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