Provider Demographics
NPI:1447479878
Name:REYNOLDS, ROLLAND CLINTON JR (MD, CWSP)
Entity type:Individual
Prefix:
First Name:ROLLAND
Middle Name:CLINTON
Last Name:REYNOLDS
Suffix:JR
Gender:M
Credentials:MD, CWSP
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Mailing Address - Street 1:2935 THOUSAND OAKS
Mailing Address - Street 2:SUITE 294
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78247-3312
Mailing Address - Country:US
Mailing Address - Phone:210-494-1100
Mailing Address - Fax:210-494-1117
Practice Address - Street 1:1305 WONDER WORLD DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7533
Practice Address - Country:US
Practice Address - Phone:512-353-6430
Practice Address - Fax:512-353-6431
Is Sole Proprietor?:No
Enumeration Date:2007-04-24
Last Update Date:2022-06-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXH2721207Q00000X, 2083A0100X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine