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General NPI Number Information
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NPI Number | 1790138881
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Entity Type | Organization
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Legal Business Name | ANTONIO REYES, MD, PA
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 07/13/2016
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Provider Practice Location Address
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Address Line | 2005 N JEFFERSON AVE
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City | MOUNT PLEASANT
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State | TX
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Zip | 75455-2336
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Country | US
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Telephone | 903-572-4381
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Fax | 903-572-9575
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Provider Business Mailing Address
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Address Line | 2005 N JEFFERSON AVE
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City | MOUNT PLEASANT
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State | TX
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Zip | 75455-2336
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Country | US
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Telephone | 903-572-4381
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Fax | 903-572-9575
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Authorized Official
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Title or Position | PHYSICIAN/PRESIDENT
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Name | DR. ANTONIO REYES
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Credential |
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Telephone | 903-572-4381
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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 | F-2876
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License Number State | TX
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