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NPI Code Detail

MEDICARE: MAIDEL REINA

MEDICARE:   MAIDEL  REINA
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
1163WA2000XAdministrator Registered Nurse895663TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1163W00000XOTHERTAXONOMY

General Provider Information

NPI Number : 1245737717
Entity Type Code : Individual
Provider Name (Legal Business Name) : MAIDEL REINA
Provider Business Mailing Address
First Line : 340 EL RIO DR
Second Line :
City : MESQUITE
State : TX
Zip : 75150-3100
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1808 S FAROLA DR
Second Line :
City : DALLAS
State : TX
Zip : 75228-2541
Country : US
Telephone Number : 214-451-7987
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/10/2018
Last Update Date : 06/11/2019

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Directions to “ MAIDEL REINA ” Practice Location

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