Individual
CHARLES A REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4515 MARSHA SHARP FWY, LUBBOCK, TX 79407-2520
(806) 744-7223
(806) 740-3325
Mailing address
2804 N LOOP 289, LUBBOCK, TX 79415-1410
(806) 744-7223
(806) 740-3325
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D9624
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100238105
FIRSTCARE
TX
01
—
4392875
AETNA
TX
01
—
8V8696
BCBS
TX
01
—
P00386643
MEDICARE RAILROAD
TX
Enumeration date
04/14/2006
Last updated
05/14/2008
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