Healthcare Provider Details

I. General information

NPI: 1447589064
Provider Name (Legal Business Name): HOMER C. REYES, M.D., PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2009
Last Update Date: 06/01/2022
Certification Date: 06/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7940 FLOYD CURL DR STE 100
SAN ANTONIO TX
78229-3907
US

IV. Provider business mailing address

14329 SAN PEDRO AVE STE C
SAN ANTONIO TX
78232-4389
US

V. Phone/Fax

Practice location:
  • Phone: 210-297-5520
  • Fax: 210-297-0632
Mailing address:
  • Phone: 210-494-2744
  • Fax: 210-494-2866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH2962
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License NumberH2962
License Number StateTX

VIII. Authorized Official

Name: HOMER C REYES
Title or Position: OWNER
Credential: M.D.
Phone: 210-643-4255