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NPI Code Detail

MEDICARE: ADRIAN REYES

MEDICARE:   ADRIAN  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
1103TC0700XClinical Psychologist36515TX

General Provider Information

NPI Number : 1558770339
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADRIAN REYES
Provider Business Mailing Address
First Line : 3102 SILVER SPRINGS WAY
Second Line :
City : ROWLETT
State : TX
Zip : 75089-2866
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3102 SILVER SPRINGS WAY
Second Line :
City : ROWLETT
State : TX
Zip : 75089-2866
Country : US
Telephone Number : 804-512-4375
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/06/2014
Last Update Date : 08/06/2014

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Directions to “ ADRIAN REYES ” Practice Location

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