MEDICARE: ELYZABETH REYES FNP-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
1	363LF0000X	Family Nurse Practitioner	AP145542	TX

General Provider Information

NPI Number	:	1780210492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELYZABETH REYES FNP-C

Provider Business Mailing Address
First Line	:	3312 N BUCKNER BLVD STE 213
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-5642
Country	:	US
Telephone Number	:	469-998-0720
Fax Number	:

Provider Business Practice Location Address
First Line	:	3312 N BUCKNER BLVD STE 213
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75228-5642
Country	:	US
Telephone Number	:	469-998-0720
Fax Number	:	877-692-4919

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

Provider Enumeration Date	:	03/14/2020
Last Update Date	:	03/30/2026

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