MEDICARE: JORDAN ALEXANDER REYES OD

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	152W00000X	Optometrist	10635	TX

General Provider Information

NPI Number	:	1396472254
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JORDAN ALEXANDER REYES OD

Provider Business Mailing Address
First Line	:	6728 ALDERBROOK DR
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76210-0017
Country	:	US
Telephone Number	:	940-453-9390
Fax Number	:

Provider Business Practice Location Address
First Line	:	7415 SOUTHWEST PKWY STE 300
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78735-8998
Country	:	US
Telephone Number	:	512-328-7300
Fax Number	:	512-328-7302

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

Provider Enumeration Date	:	08/02/2022
Last Update Date	:	03/23/2026

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