Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 22377 | TX |
Y | 213EG0000X | General Practice | 22377 | TX |
NPI | 1003948720 |
---|---|
Provider Name | Cecelia Reid |
First Address | Rosenberg, TX 77471-2038 |
Second Address | Rosenberg, TX 77471-2038 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2007 |
Last Update Date | 07/02/2017 |