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General NPI Number Information
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NPI Number | 1336408830
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Entity Type | Individual
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Provider Name | MISHANTA REYES D.O.
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Gender | Female
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Dates
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Enumeration Date | 05/04/2012
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 401 LOWELL DR SE STE 5
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City | HUNTSVILLE
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State | AL
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Zip | 35801-3738
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Country | US
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Telephone | 256-265-4462
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Fax | 256-265-4463
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Provider Business Mailing Address
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Address Line | PO BOX 21007
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City | HUNTSVILLE
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State | AL
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Zip | 35813-5007
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Country | US
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Telephone | 256-801-6321
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Fax | 256-801-6218
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 1800
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License Number State | AL
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