Healthcare Provider Details

I. General information

NPI: 1780230037
Provider Name (Legal Business Name): PATRICIA REYES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: PATTY REYES NP

II. Dates (important events)

Enumeration Date: 08/13/2019
Last Update Date: 11/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5950 SARATOGA BLVD
CORPUS CHRISTI TX
78414-4100
US

IV. Provider business mailing address

3701 LOCKE LN
CORPUS CHRISTI TX
78415-3922
US

V. Phone/Fax

Practice location:
  • Phone: 361-985-5811
  • Fax: 361-985-5645
Mailing address:
  • Phone: 361-331-1911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP142562
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: