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General NPI Number Information
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NPI Number | 1316126964
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Entity Type | Organization
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Legal Business Name | JONATHAN DELOS REYES, M.D.
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Dates
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Enumeration Date | 10/31/2007
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Last Update Date | 10/31/2007
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Provider Practice Location Address
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Address Line | 4308 MESA DR STE A
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City | DENTON
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State | TX
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Zip | 76207-3459
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Country | US
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Telephone | 940-565-0600
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Fax | 940-565-1538
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Provider Business Mailing Address
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Address Line | 4308 MESA DR STE A
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City | DENTON
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State | TX
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Zip | 76207-3459
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Country | US
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Telephone | 940-565-0600
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Fax | 940-565-1538
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. KAREN SIGTENHORST
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Credential |
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Telephone | 940-565-0600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | K8112
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License Number State | TX
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