Basic Information
| Provider Information | |||||||||
| NPI: | 1083915953 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | REED | ||||||||
| FirstName: | JAMIE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1101 N CARRIER PKWY | ||||||||
| Address2: | E | ||||||||
| City: | GRAND PRAIRIE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 750503382 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9722371482 | ||||||||
| FaxNumber: | 9722375660 | ||||||||
| Practice Location | |||||||||
| Address1: | 99 N LA CIENEGA BLVD STE 200 | ||||||||
| Address2: | |||||||||
| City: | BEVERLY HILLS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 90211 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3106579353 | ||||||||
| FaxNumber: | 3106579367 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2010 | ||||||||
| LastUpdateDate: | 07/13/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 11461 | TX | N | Chiropractic Providers | Chiropractor | 363LF0000X | AP126697 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 95008811 | CA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.