Organization
RED RIVER NEPHROLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID GLENN REYNOLDS I MD (PRESIDENT/PROVIDER)
(903) 893-7170
Entity
Organization
Contact information
Practice address
321 N HIGHLAND AVE, SUITE 105, SHERMAN, TX 75092-7378
(903) 893-7170
(903) 893-4372
Mailing address
321 N HIGHLAND AVE, SUITE 105, SHERMAN, TX 75092-7378
(903) 893-7170
(903) 893-4372
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
H6541
TX
207RN0300X
Nephrology Physician
H6541
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00K55R
BCBS OF TEXAS
TX
05
—
1736996
—
LA
01
—
4333749
AETNA
—
Enumeration date
05/28/2006
Last updated
08/15/2007
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