Provider Demographics
NPI:1326046376
Name:REEVES, ROBERT DAVID (M D)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DAVID
Last Name:REEVES
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9180 PINECROFT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-3880
Mailing Address - Country:US
Mailing Address - Phone:281-367-6836
Mailing Address - Fax:281-367-5545
Practice Address - Street 1:9180 PINECROFT DR STE 100
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77380
Practice Address - Country:US
Practice Address - Phone:281-368-6836
Practice Address - Fax:281-367-5545
Is Sole Proprietor?:No
Enumeration Date:2005-07-13
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE4626174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2854978-018OtherCIGNA
TX3231591OtherAETNA HMO
TX4213758OtherAETNA PPO
TX2854978-017OtherCIGNA
TX2854978-019OtherCIGNA
TX347469406Medicaid
TXP00064367OtherMEDICARE RAILROAD
TX57270OtherAMERICAID
TX8J1220OtherBCBS PROVIDER #
TX8A6654Medicare ID - Type UnspecifiedMEDICARE
TX347469406Medicaid