Healthcare Provider Details

I. General information

NPI: 1639080443
Provider Name (Legal Business Name): MICHELLE CELESTE REYES PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2026
Last Update Date: 09/14/2026
Certification Date: 09/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21216 NORTHWEST FWY STE 620
CYPRESS TX
77429-4699
US

IV. Provider business mailing address

2807 OAK RIDGE PARK DR
HOUSTON TX
77084-6110
US

V. Phone/Fax

Practice location:
  • Phone: 281-607-4021
  • Fax:
Mailing address:
  • Phone: 832-362-8123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number2188717
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: