MEDICARE: LOUIS C REYES M.D.

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	208600000X	Surgery Physician	F3589	TX
2	208D00000X	General Practice Physician	F3589	TX

General Provider Information

NPI Number	:	1720243298
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LOUIS C REYES M.D.

Provider Business Mailing Address
First Line	:	2054 WIRT RD STE E
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-2474
Country	:	US
Telephone Number	:	713-551-1785
Fax Number	:	713-263-7244

Provider Business Practice Location Address
First Line	:	2054 WIRT RD STE E
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77055-2474
Country	:	US
Telephone Number	:	713-551-1785
Fax Number	:	713-263-7244

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

Provider Enumeration Date	:	07/24/2008
Last Update Date	:	12/06/2010

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