Organization
DKJJ, INC
Active
Other names
Reagan Eye Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID W. REAGAN M.D. (PRESIDENT)
(972) 938-7909
Entity
Organization
Contact information
Practice address
101 YMCA DR, WAXAHACHIE, TX 75165-5124
(972) 938-7909
(972) 938-2966
Mailing address
101 YMCA DR, WAXAHACHIE, TX 75165-5124
(972) 938-7909
(972) 938-2966
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
008283
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HH109A
BCBS PROVIDER NUMBER
TX
01
—
P00284959
MEDICARE RAILROAD
TX
Enumeration date
11/20/2006
Last updated
03/12/2008
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