Provider Demographics
NPI:1164449096
Name:DIANA REYES
Entity Type:Organization
Organization Name:DIANA REYES
Other - Org Name:BEST MEDICAL SUPPLY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:915-532-3030
Mailing Address - Street 1:702 E YANDELL DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-5314
Mailing Address - Country:US
Mailing Address - Phone:915-532-3030
Mailing Address - Fax:915-532-3032
Practice Address - Street 1:702 E YANDELL DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5314
Practice Address - Country:US
Practice Address - Phone:915-532-3030
Practice Address - Fax:915-532-3032
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-16
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0079218332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX147750701Medicaid
TX147749901Medicaid
TX147750701Medicaid