Reagan, Brendan W

Reagan, Brendan W is an individual health care provider with primary practice located at 1300 W Terrell Ave Suite 500, Fort Worth TX 76104-2820. He recently has 4 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Reagan, Brendan W can be contacted via phone (817) 252-5000.

Contact Information

Primary practice address
1300 W Terrell Ave Suite 500 Fort Worth TX 76104-2820
Phone: (817) 252-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 42929 Tennessee
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X P2158 Texas
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X P2158 Texas

Profile Details

NPI number 1275680076
LBN Legal business name Reagan, Brendan W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2007
Last updated Aug 18th, 2014 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275680076 NPPES
Other 0009880173 AETNA
MEDICAID 305771301 AETNA
MEDICAID 1506020 AETNA
Other 7100051780 AETNA
Other 4190818 AETNA

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