MEDICARE: MR. JOHN REYES RN, MSN, ACNP

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	363LA2100X	Acute Care Nurse Practitioner	267815	MA
2	363LA2100X	Acute Care Nurse Practitioner	783952	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518142371
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN REYES RN, MSN, ACNP

Provider Business Mailing Address
First Line	:	6565 FANNIN
Second Line	:	ALKEK 754
City	:	HOUSTON
State	:	TX
Zip	:	77030
Country	:	US
Telephone Number	:	713-441-4565
Fax Number	:

Provider Business Practice Location Address
First Line	:	3275 COLLEGE PARK DR
Second Line	:
City	:	THE WOODLANDS
State	:	TX
Zip	:	77384-4501
Country	:	US
Telephone Number	:	346-220-8063
Fax Number	:	832-838-4362

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

Provider Enumeration Date	:	12/29/2007
Last Update Date	:	04/08/2024

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