Provider Demographics
NPI:1538341276
Name:PATRICK D. REEVES,M.D.,P.A.
Entity type:Organization
Organization Name:PATRICK D. REEVES,M.D.,P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICK
Authorized Official - Middle Name:DARREN
Authorized Official - Last Name:REEVES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-792-2104
Mailing Address - Street 1:4315 28TH ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79410-2507
Mailing Address - Country:US
Mailing Address - Phone:806-792-2104
Mailing Address - Fax:806-792-2134
Practice Address - Street 1:4315 28TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79410-2507
Practice Address - Country:US
Practice Address - Phone:806-792-2104
Practice Address - Fax:806-792-2134
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK6263207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0081JQOtherBLUE CROSS
TX00467UMedicare PIN