MEDICARE: IVETTE M. REYES MSN, APRN, 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	1032824	TX

General Provider Information

NPI Number	:	1851971071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	IVETTE M. REYES MSN, APRN, FNP-C

Provider Business Mailing Address
First Line	:	8318 JONES MALTSBERGER RD STE 126
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-6506
Country	:	US
Telephone Number	:	210-233-6393
Fax Number	:	866-853-0474

Provider Business Practice Location Address
First Line	:	8318 JONES MALTSBERGER RD STE 126
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78216-6506
Country	:	US
Telephone Number	:	210-233-6393
Fax Number	:	866-853-0474

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

Provider Enumeration Date	:	04/12/2021
Last Update Date	:	05/18/2026

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