Basic Information
| Provider Information | |||||||||
| NPI: | 1760457428 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REITMEYER | ||||||||
| FirstName: | MARGARET | ||||||||
| MiddleName: | R | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 846098 | ||||||||
| Address2: | |||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752846098 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9033246450 | ||||||||
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| Practice Location | |||||||||
| Address1: | 619 S FLEISHEL AVE | ||||||||
| Address2: | STE 327 | ||||||||
| City: | TYLER | ||||||||
| State: | TX | ||||||||
| PostalCode: | 757012004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9035101173 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/17/2006 | ||||||||
| LastUpdateDate: | 09/25/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | L0539 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RE0101X | L0539 | TX | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism |
ID Information
| ID | Type | State | Issuer | Description | 75-2616977-042 | 01 | TX | TRICARE | OTHER | 037743402 | 05 | TX | MEDICAID | 123501 | 01 | TX | SUPERIOR/CHIPS | OTHER | 752616977012 | 01 | TX | TRICARE | OTHER | 037743403 | 05 | TX | MEDICAID | 80372G | 01 | TX | BCBS OF TEXAS | OTHER | 037743401 | 05 | TX | MEDICAID | 5643551 | 01 | TX | AETNA | OTHER |