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Individual

REAGAN LEE CROSSNOE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
7120 SW 9TH AVE, AMARILLO, TX 79106-1704
(806) 547-0330
(806) 547-0331
Mailing address
7120 SW 9TH AVE, AMARILLO, TX 79106-1704
(806) 547-0330
(806) 547-0331

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
K9511
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0090JU
BLUE CROSS BLUE SHIELD
05
157236401
TX
01
E00820587843
AETNA
TX
01
P00010069
RAILROAD MEDICARE
TX
Enumeration date
10/21/2005
Last updated
11/21/2022
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