Reedy, Mark Brendan
Reedy, Mark Brendan is an individual health care provider with primary practice located at 602 Indiana Ave , Lubbock TX 79415-3364. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gynecologic Oncology, which is considered as his primary health care specialty. Reedy, Mark Brendan can be contacted via phone (806) 775-8600.Contact Information
Primary practice address
602 Indiana Ave
Lubbock TX 79415-3364
Phone: (806) 775-8600
Fax: (806) 775-8586
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gynecologic Oncology | 207VX0201X | H8348 | Texas |
Profile Details
| NPI number | 1487659876 |
|---|---|
| LBN Legal business name | Reedy, Mark Brendan |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 14th, 2005 |
| Last updated | Mar 16th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487659876 | NPPES |
| Texas | MEDICAID | 122327308 | |
| Texas | MEDICAID | 122327315 | |
| Texas | MEDICAID | 122327306 | |
| Texas | Other | H08KE62101 |
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