Provider Demographics
NPI:1316103294
Name:REED, ALISA MANUEL (DDS)
Entity type:Individual
Prefix:DR
First Name:ALISA
Middle Name:MANUEL
Last Name:REED
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 MEDICAL PLAZA DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3249
Mailing Address - Country:US
Mailing Address - Phone:281-367-3411
Mailing Address - Fax:281-367-3538
Practice Address - Street 1:1011 MEDICAL PLAZA DR
Practice Address - Street 2:SUITE 120
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-3249
Practice Address - Country:US
Practice Address - Phone:281-367-3411
Practice Address - Fax:281-367-3538
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18936122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist