Provider Demographics
NPI:1528112646
Name:REED, TROY CHRISTOPHER (CRNA)
Entity type:Individual
Prefix:
First Name:TROY
Middle Name:CHRISTOPHER
Last Name:REED
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:SEGUIN
Mailing Address - State:TX
Mailing Address - Zip Code:78155-5129
Mailing Address - Country:US
Mailing Address - Phone:810-987-5000
Mailing Address - Fax:810-985-2633
Practice Address - Street 1:1215 E COURT ST
Practice Address - Street 2:
Practice Address - City:SEGUIN
Practice Address - State:TX
Practice Address - Zip Code:78155-5129
Practice Address - Country:US
Practice Address - Phone:810-987-5000
Practice Address - Fax:810-985-2633
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704212267367500000X
TXAP131726367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704212267OtherLICENSE