Individual
RICKEY J REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
400 ROSALIND REDFERN GROVER PKWY STE 120, MIDLAND, TX 79701-5849
(432) 221-3700
(432) 685-0834
Mailing address
4214 ANDREWS HWY STE 240, MIDLAND, TX 79703-4817
(432) 686-6605
(432) 682-2284
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
47762
MN
2084N0400X
Neurology Physician
Primary
J4474
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110523000
—
MN
05
—
1316099153
—
TX
05
—
203416702
—
TX
01
—
752616977052
TRICARE
TX
01
—
8TL498
BCBS TX
TX
01
—
8W6745
BCBS
TX
Enumeration date
01/18/2007
Last updated
11/30/2023
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