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NPI Code Detail

MEDICARE: ROSA V REYNA MA, SLP

MEDICARE: ROSA V REYNA MA, SLP
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
1235Z00000XSpeech-Language Pathologist13266TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
188054TOTHERTXBCBS PROVIDER NUMBER

General Provider Information

NPI Number : 1912113176
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSA V REYNA MA, SLP
Provider Business Mailing Address
First Line : 2301 ELLA ST
Second Line :
City : HARLINGEN
State : TX
Zip : 78550-4450
Country : US
Telephone Number : 956-440-1155
Fax Number :
Provider Business Practice Location Address
First Line : 801 N ED CAREY DR
Second Line :
City : HARLINGEN
State : TX
Zip : 78550-7919
Country : US
Telephone Number : 956-440-1155
Fax Number : 956-440-0913
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2007
Last Update Date : 07/08/2007

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Directions to “ ROSA V REYNA MA, SLP” Practice Location

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