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Individual
SHELLIE ALESHA REAGAN
Active
Individual
SHELLIE ALESHA REAGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
15755
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15755
BLUE CROSS BLUE SHIELD
TX
01
—
681227
UNITED CONCORDIA
TX
Enumeration date
08/19/2006
Last updated
08/27/2012
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