MEDICARE: DR. ANTONIO F. REYES PHARMD

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	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	03180	PR

General Provider Information

NPI Number	:	1851373732
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANTONIO F. REYES PHARMD

Provider Business Mailing Address
First Line	:	5001 N PIEDRAS ST
Second Line	:	EL PASO VAHCS
City	:	EL PASO
State	:	TX
Zip	:	79930-4210
Country	:	US
Telephone Number	:	915-564-6100
Fax Number	:

Provider Business Practice Location Address
First Line	:	5005 N PIEDRAS ST
Second Line	:	WILLIAM BEAUMONT ARMY MEDICAL CENTER
City	:	EL PASO
State	:	TX
Zip	:	79920-5001
Country	:	US
Telephone Number	:	915-569-2170
Fax Number	:

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

Provider Enumeration Date	:	11/16/2005
Last Update Date	:	08/10/2015

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