Provider Demographics
NPI:1003930595
Name:REYES, MERLI MABEL (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:MERLI
Middle Name:MABEL
Last Name:REYES
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3133 W NORTHGATE DR APT 1127
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75062-3147
Mailing Address - Country:US
Mailing Address - Phone:214-608-7356
Mailing Address - Fax:
Practice Address - Street 1:815 N O CONNOR RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75061-4510
Practice Address - Country:US
Practice Address - Phone:972-579-0511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2801-0104-0357-365183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician