Reformed Holding LLC

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

Legal business name

REFORMED HOLDING LLC

Practice address

4435 McEwen Rd Ste 200
Dallas, TX 75244-5206

Phone

(214) 945-9666

Fax

(214) 988-3033

NPI assigned

Oct 4, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Travis M Mann

Title

Owner

Phone

(214) 945-9666

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1538611200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1538611200000",
    "number": "1922573138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4435 MCEWEN RD STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4435 MCEWEN RD STE 200",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752445206",
            "telephone_number": "214-945-9666",
            "fax_number": "214-988-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REFORMED HOLDING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-04",
        "last_updated": "2018-10-04",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "TRAVIS",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-945-9666"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• General Practice Physician in Dallas, TX
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• General Practice Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.