Basic Information
Provider Information
NPI: 1922581164
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: REEH
FirstName: ERIN
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: PTA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1107 AUSTIN AVE
Address2:  
City: COLLEGE STATION
State: TX
PostalCode: 778455135
CountryCode: US
TelephoneNumber: 2102690873
FaxNumber:  
Practice Location
Address1: 1105 ROCK PRAIRIE RD
Address2:  
City: COLLEGE STATION
State: TX
PostalCode: 778458344
CountryCode: US
TelephoneNumber: 9796942200
FaxNumber:  
Other Information
ProviderEnumerationDate: 09/13/2018
LastUpdateDate: 09/13/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225200000X2076776TXY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant 

No ID Information.


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