MARK BRENDAN REEDY


Address: 602 Indiana Ave, Lubbock, TX 79415-3364
Phone: 8067758600

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).

Provider Overview

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

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207VX0201X Obstetrics & Gynecology
Specialization: Gynecologic Oncology
H8348 TX Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
TX 122327315 05
TX BCBS H08KE62101 01
TX 122327308 05
TX 122327306 05

Provider Secondary Practice Location

Address Telephone Number Fax Number
2821 Michaelangelo Dr Ste 202, Edinburg, TX 785391406 9563622465 9563622466

Other Providers MARK REEDY

NPI Name Taxonomy Address Enumeration
1508944596 Mark A Reedy Family Medicine 3631 N. Morrison Road, Suite 200, Muncie, IN 47304 2006-11-01

Office Location

Street Address 602 INDIANA AVE
City LUBBOCK
State TX
Zip Code 79415-3364

Providers in the same location

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
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Providers in the same zip code

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
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Taxonomy Information

Taxonomy Code 207VX0201X
Grouping Allopathic & Osteopathic Physicians
Classification Obstetrics & Gynecology
Specialization Gynecologic Oncology

Taxonomy Definition

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.

Providers in the same taxonomy and city

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

Providers in the same taxonomy and state

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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Competitor

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City LUBBOCK
Zip Code 79415

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Dataset Information

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.

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