MEDICARE: EMMA LUISA REYES LVN

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	164X00000X	Licensed Vocational Nurse	198869	TX

General Provider Information

NPI Number	:	1861204562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMA LUISA REYES LVN

Provider Business Mailing Address
First Line	:	14618 HIGHLAND RDG
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78233-3840
Country	:	US
Telephone Number	:	830-513-3439
Fax Number	:

Provider Business Practice Location Address
First Line	:	16019 NACOGDOCHES RD STE 101
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78247-1128
Country	:	US
Telephone Number	:	210-617-5300
Fax Number	:	210-443-0324

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

Provider Enumeration Date	:	01/21/2025
Last Update Date	:	01/21/2025

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Directions to “ EMMA LUISA REYES LVN” Practice Location

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