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NPI Code Detail

MEDICARE: ROBERT REYES CST

MEDICARE: ROBERT REYES CST
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
1247200000XOther Technician077829NV

General Provider Information

NPI Number : 1578691945
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROBERT REYES CST
Provider Business Mailing Address
First Line : 600 S RANCHO DR
Second Line : #107
City : LAS VEGAS
State : NV
Zip : 89106-4806
Country : US
Telephone Number : 702-878-8370
Fax Number : 702-259-1026
Provider Business Practice Location Address
First Line : 600 S RANCHO DR
Second Line : #107
City : LAS VEGAS
State : NV
Zip : 89106-4806
Country : US
Telephone Number : 702-878-8370
Fax Number : 702-259-1026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2007
Last Update Date : 10/11/2007

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Directions to “ ROBERT REYES CST” Practice Location

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