MEDICARE: RANIER REYES

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	2084A2900X	Neurocritical Care Physician	R7579	TX

General Provider Information

NPI Number	:	1043637333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANIER REYES

Provider Business Mailing Address
First Line	:	1711 OLD SPANISH TRL APT 343
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1961
Country	:	US
Telephone Number	:	832-643-0874
Fax Number	:

Provider Business Practice Location Address
First Line	:	1711 OLD SPANISH TRL APT 343
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1961
Country	:	US
Telephone Number	:	832-643-0874
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/25/2014
Last Update Date	:	01/26/2021

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Directions to “ RANIER REYES ” Practice Location

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