MARK BRENDAN REEDY (NPI# 1487659876) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487659876 |
| Entity Type | Individual |
| Full Name | MARK BRENDAN REEDY |
| Credential | MD |
| Practice Address |
602 Indiana Ave Lubbock TX 79415-3364 |
| Mailing Address |
4707 117th St Lubbock TX 79424-7613 |
| Practice Telephone | 8067758600 |
| Practice Fax Number | 8067431025 |
| Mailing Telephone | 3256650118 |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2020-01-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
H8348 | TX | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 122327315 | 05 | |
| TX | BCBS | H08KE62101 | 01 |
| TX | 122327308 | 05 | |
| TX | 122327306 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 2821 Michaelangelo Dr Ste 202, Edinburg, TX 785391406 | 9563622465 | 9563622466 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508944596 | Mark A Reedy | Family Medicine | 3631 N. Morrison Road, Suite 200, Muncie, IN 47304 | 2006-11-01 |
| Street Address |
602 INDIANA AVE |
| City | LUBBOCK |
| State | TX |
| Zip Code | 79415-3364 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417571613 | Chelsea Brooke Seaton | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-06-03 |
| 1437773728 | John Clinton Fisher IIi | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-06-02 |
| 1700409448 | Ryan Everett Hirata | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-05-28 |
| 1013530716 | Lillian Amezquita | Student in an Organized Health Care Education/Training Program | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2020-05-28 |
| 1457990186 | Madison Dreu Williams | Registered Nurse | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-12-28 |
| 1972145977 | Alicia Garcia Castanon | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-10-10 |
| 1770133746 | Candace Kernell | Registered Nurse | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-09-12 |
| 1154883767 | James William Woodwick Jr. | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-04-02 |
| 1811455066 | Rolando Adolfo Lugo II | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-03-06 |
| 1114483799 | Rey David Valdez | Nurse Practitioner | 602 Indiana Ave, Lubbock, TX 79415-3364 | 2019-02-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831569540 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3502 9th St Ste 280, Lubbock, TX 79415 | 2015-10-07 |
| 1922447457 | Fnu Parijat Kumar | Physical Therapist | 2717 3rd Street, Aptt 803, Lubbock, TX 79415 | 2013-06-18 |
| 1851575906 | Diego Rivera, M.d., P.a. | Family Medicine | 111 University Ave, Lubbock, TX 79415 | 2007-12-26 |
| 1730206632 | Kathleen Brinkman Felts | Physical Therapist | 3710 4th Street, Lubbock, TX 79415 | 2007-03-23 |
| 1568508521 | Horace Rueben Sharp Jr. | Optometrist | 1911 4th St, Lubbock, TX 79415 | 2007-01-29 |
| 1699876201 | Patricia R. Arledge | Plastic Surgery | 3502 9th St., Suite 270, Lubbock, TX 79415 | 2006-09-26 |
| 1245330018 | Perlita Molina Sambrano-tandoc | Nurse Practitioner | 602 East Indiana Avenue, Lubbock, TX 79415 | 2006-09-22 |
| 1639199862 | Justin Tidwell | Emergency Medicine | 604 Indiana, Lubbock, TX 79415 | 2006-07-20 |
| 1912944059 | Community Health Center of Lubbock, Inc. | Clinic/Center | 3301 Clovis Road, Lubbock, TX 79415 | 2006-05-31 |
| 1497709265 | Byron Wayne Schoettle | Radiology | 602 Indiana Avenue, Lubbock, TX 79415 | 2006-05-19 |
| Find all providers in zip 79415 | ||||
| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073042859 | Women's Oncology, Pllc | Obstetrics & Gynecology | 3612 22nd Pl, Lubbock, TX 79410-1318 | 2017-06-06 |
| 1639579311 | Gynecologic Oncology Associates Pllc | Obstetrics & Gynecology | 3621 22nd St, Suite 100, Lubbock, TX 79410-1301 | 2014-08-29 |
| 1962497305 | Benny Pothen Phillips | Obstetrics & Gynecology | 3621 22nd St, Suite 100, Lubbock, TX 79410-1301 | 2005-09-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235779299 | Beverly Gail Hutzler | Obstetrics & Gynecology | 4502 Medical Dr # 71-1, San Antonio, TX 78229-4402 | 2020-01-07 |
| 1548827496 | Jeffrey Andrew How | Obstetrics & Gynecology | 1155 Herman Pressler, Unit 1362, Houston, TX 77030-4000 | 2019-05-28 |
| 1790123156 | Hatem Hatem | Obstetrics & Gynecology | 7719 S Ih 35 Ste 220, San Antonio, TX 78224-1469 | 2013-06-07 |
| 1619286465 | Behrouz Zand | Obstetrics & Gynecology | 18100 St. John Dr., Suite 250, Nassau Bay, TX 77058 | 2010-09-28 |
| 1033435367 | Abel Moron | Obstetrics & Gynecology | 12200 Park Central Dr Ste 410, Dallas, TX 75251-2101 | 2010-04-12 |
| 1043295728 | Christine M. Lee | Obstetrics & Gynecology | 920 Medical Plaza Dr Ste 300, Shenandoah, TX 77380-3256 | 2005-12-14 |
| 1467435982 | Carlos Alberto Herrera | Obstetrics & Gynecology | 2717 Michael Angelo, Ste 304, Edinburg, TX 78539 | 2005-11-29 |
| 1447232467 | John L. Dalrymple | Obstetrics & Gynecology | 911 W 38th St, Suite 202, Austin, TX 78705-1188 | 2005-11-16 |
| 1184615452 | Edward Robert Kost | Obstetrics & Gynecology | 903 W Martin St, San Antonio, TX 78207-0903 | 2005-11-04 |
| 1376017715 | Oncology Specialists of Texas, Pllc | Obstetrics & Gynecology | 17350 St Lukes Way Ste 350, The Woodlands, TX 77384-4103 | 2019-01-18 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.