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NPI Code Detail

MEDICARE: ZOILA REYNA BARRERA PA-C

MEDICARE: ZOILA REYNA BARRERA PA-C
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
1363AS0400XSurgical Physician AssistantPA03369TX
2363AS0400XSurgical Physician Assistant085.002951IL
3363AM0700XMedical Physician AssistantPA03369TX
4363AS0400XSurgical Physician AssistantGA005528GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2970026640OTHERTXRAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number : 1659361970
Entity Type Code : Individual
Provider Name (Legal Business Name) : ZOILA REYNA BARRERA PA-C
Provider Business Mailing Address
First Line : 720 GOLDER AVE
Second Line :
City : ODESSA
State : TX
Zip : 79761-4442
Country : US
Telephone Number : 432-337-3117
Fax Number :
Provider Business Practice Location Address
First Line : 720 GOLDER AVE
Second Line :
City : ODESSA
State : TX
Zip : 79761-4442
Country : US
Telephone Number : 432-337-3117
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2005
Last Update Date : 01/03/2014

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Directions to “ ZOILA REYNA BARRERA PA-C” Practice Location

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