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:
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Health care specialties

SpecialtyCodeLicense #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 5 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 1487659876 NPPES
Texas MEDICAID 122327308
Texas MEDICAID 122327315
Texas MEDICAID 122327306
Texas Other H08KE62101

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