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General NPI Number Information
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NPI Number | 1790427649
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Entity Type | Individual
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Provider Name | GUNNAR MAXIMILLIAN REICHENBERGER DO
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Gender | Male
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Dates
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Enumeration Date | 04/11/2022
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 6001 KYLE PKWY
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City | KYLE
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State | TX
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Zip | 78640-6112
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Country | US
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Telephone | 512-504-5000
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Fax | 512-324-1017
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Provider Business Mailing Address
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Address Line | 6431 FANNIN STREET SUITE JJL 2ND FLOOR
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City | HOUSTON
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State | TX
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Zip | 77030
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Country | US
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Telephone | 713-500-7882
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Fax | 713-500-0758
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | V2239
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License Number State | TX
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