Provider Demographics
NPI:1295217032
Name:REYES, RICHARD D (OPTICIAN)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:D
Last Name:REYES
Suffix:
Gender:M
Credentials:OPTICIAN
Other - Prefix:
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Mailing Address - Street 1:115 E TRAVIS ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205-1668
Mailing Address - Country:US
Mailing Address - Phone:210-884-1732
Mailing Address - Fax:210-885-1732
Practice Address - Street 1:115 E TRAVIS ST STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205-1668
Practice Address - Country:US
Practice Address - Phone:210-884-1732
Practice Address - Fax:210-885-1732
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-29
Last Update Date:2018-08-29
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician