BRECKWOLDT, REID DOUGLAS - Licensee Information

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Last Update: Friday, September 27, 2024 3:50 AM CDT
Next Update: Friday, September 27, 2024 12:00 PM CDT

BRECKWOLDT, REID DOUGLAS

Practice Address:	ENVISION PHYSICIAN SERVICES F/K/A RAYS 13737 NOEL RD. STE 1600-RAYS DALLAS TX 75240 Address last updated on 9/25/2024
Phone #:	(480) 207-4092
Fax #:
County:	NOT OKLAHOMA
License:	31871
Dated:	10/19/2015
Expires:	10/1/2024
Temp. Lic. Issued:	9/30/2015
Temp. Lic. Expires:	11/6/2015
License Type:	Medical Doctor
Specialty:	Diagnostic Radiology

Status:	Active
Status Class:	Fully Licensed
Restricted to:
Registered to Dispense:	NO
Medical School:	Univ Of Sc Sch Of Med, Columbia Sc 29208
Graduated:	5 / 1993
CME Year:	2024

Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.

All information below is entered by the licensee but not verified by the Oklahoma Medical Board.

Certifications:	AMERICAN BOARD OF RADIOLOGY (Diagnostic Radiology specific)
New Patients:	Contact licensee
Medicaid:	Contact licensee
Medicare:	Contact licensee

HMO/PPO:	None listed
Hospital Privileges:	None listed

Locations:	Hours:	Languages:
ENVISION PHYSICIAN SERVICES F/K/A RAYS 13737 NOEL RD. STE 1600-RAYS DALLAS TX 75240 Phone #: (480) 207-4092 Fax #:	Mon: Tue: Wed: Thu: Fri: Sat: Sun: