Reynolds, Timothy J
Reynolds, Timothy J is an individual health care provider with primary practice located at 508 Medical Center Blvd Ste 200, Conroe TX 77304-2808. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Reynolds, Timothy J can be contacted via phone (936) 760-4600.Contact Information
Primary practice address
508 Medical Center Blvd Ste 200
Conroe TX 77304-2808
Phone: (936) 760-4600
Fax: (936) 760-4601
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | K9159 | Texas |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | K9159 | Texas |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | K9159 | Texas |
Profile Details
| NPI number | 1376554691 |
|---|---|
| LBN Legal business name | Reynolds, Timothy J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 11th, 2006 |
| Last updated | Nov 15th, 2012 - about 12 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 | 1376554691 | NPPES |
| Texas | Other | 094010801 | MEDICAID GROUP NUMBER |
| Texas | MEDICAID | 164601003 | MEDICAID GROUP NUMBER |
| Texas | Other | 00J21A | MEDICAID GROUP NUMBER |
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