Individual
NICOLE LESLEY REID
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2601 THORNTON LN, TEMPLE, TX 76502-1808
(254) 724-2111
(254) 235-1056
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2007011080
MO
208600000X
Surgery Physician
Primary
P7553
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140GN
BCBS NC
NC
05
—
5901629
—
NC
01
—
P7553
MEDICARE
TX
Enumeration date
01/17/2007
Last updated
03/21/2024
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