Provider Demographics
NPI:1063785665
Name:REESE, LINDA ATLAS (DO)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ATLAS
Last Name:REESE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:LINDA
Other - Middle Name:EDITH
Other - Last Name:ATLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1001 N RHEA DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76108-3565
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1001 N RHEA DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76108-3565
Practice Address - Country:US
Practice Address - Phone:817-946-1628
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9761208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice