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NPI Code Detail

MEDICARE: STEPHAN REYES MD

MEDICARE: STEPHAN REYES MD
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
1207RP1001XPulmonary Disease PhysicianW5529TX
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1780249300
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHAN REYES MD
Provider Business Mailing Address
First Line : 241 W 11TH AVE STE 5082
Second Line :
City : COLUMBUS
State : OH
Zip : 43201-2356
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2240 GULF FWY S
Second Line :
City : LEAGUE CITY
State : TX
Zip : 77573-5143
Country : US
Telephone Number : 832-632-6500
Fax Number : 409-772-9532
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/08/2019
Last Update Date : 06/02/2026

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Directions to “ STEPHAN REYES MD” Practice Location

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