MEDICARE: MS. ANGELINA L REYNA PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA10420	TX

General Provider Information

NPI Number	:	1205299492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ANGELINA L REYNA PA

Provider Business Mailing Address
First Line	:	3809 W BUSINESS 83
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78552-3521
Country	:	US
Telephone Number	:	956-364-0325
Fax Number	:

Provider Business Practice Location Address
First Line	:	3809 W BUSINESS 83
Second Line	:
City	:	HARLINGEN
State	:	TX
Zip	:	78552-3521
Country	:	US
Telephone Number	:	956-364-0325
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/04/2016
Last Update Date	:	08/10/2021

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