MEDICARE: PATRICIA B REYES DMD PLLC

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1205552189
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATRICIA B REYES DMD PLLC

Provider Business Mailing Address
First Line	:	PO BOX 70887
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44190-0887
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1205 JUNCTION HWY
Second Line	:
City	:	KERRVILLE
State	:	TX
Zip	:	78028-5198
Country	:	US
Telephone Number	:	830-253-4360
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	PATRICIA REYES
Credential	:
Telephone Number	:	830-253-4360

Provider Enumeration Date	:	10/13/2022
Last Update Date	:	06/13/2023

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