Provider Demographics
NPI:1992822332
Name:REID, STEPHANIE LYN (DC)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:LYN
Last Name:REID
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:108 E FM 2410 RD
Mailing Address - Street 2:STE H
Mailing Address - City:HARKER HEIGHTS
Mailing Address - State:TX
Mailing Address - Zip Code:76548-1882
Mailing Address - Country:US
Mailing Address - Phone:254-680-4325
Mailing Address - Fax:254-680-4196
Practice Address - Street 1:108 E FM 2410 RD
Practice Address - Street 2:STE H
Practice Address - City:HARKER HEIGHTS
Practice Address - State:TX
Practice Address - Zip Code:76548-1882
Practice Address - Country:US
Practice Address - Phone:254-680-4325
Practice Address - Fax:254-680-4196
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX6753111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor