Provider Demographics
NPI:1548476492
Name:REID, KARY STEVEN (PHD)
Entity type:Individual
Prefix:DR
First Name:KARY
Middle Name:STEVEN
Last Name:REID
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 65600
Mailing Address - Street 2:#125
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79464-5600
Mailing Address - Country:US
Mailing Address - Phone:806-794-1336
Mailing Address - Fax:
Practice Address - Street 1:1920 31ST ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79411-1810
Practice Address - Country:US
Practice Address - Phone:806-794-1336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2011-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2287106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist