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NPI Code Detail

MEDICARE: ELISA REYES

MEDICARE: ELISA 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
1106H00000XMarriage & Family Therapist204449TX

General Provider Information

NPI Number : 1699558643
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELISA REYES
Provider Business Mailing Address
First Line : 2631 GATTIS SCHOOL RD STE 135
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-2828
Country : US
Telephone Number : 512-298-1324
Fax Number :
Provider Business Practice Location Address
First Line : 2631 GATTIS SCHOOL RD STE 135
Second Line :
City : ROUND ROCK
State : TX
Zip : 78664-2828
Country : US
Telephone Number : 512-298-1324
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2023
Last Update Date : 08/15/2023

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Directions to “ ELISA REYES ” Practice Location

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