Provider Demographics
NPI:1356841365
Name:REYES-ROMAN, MERARI (RN)
Entity Type:Individual
Prefix:MRS
First Name:MERARI
Middle Name:
Last Name:REYES-ROMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7220 MCCALLUM BLVD APT 1502
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75252-6173
Mailing Address - Country:US
Mailing Address - Phone:972-537-7137
Mailing Address - Fax:
Practice Address - Street 1:7114 TOLAND ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75227-3835
Practice Address - Country:US
Practice Address - Phone:972-537-7137
Practice Address - Fax:972-537-7137
Is Sole Proprietor?:No
Enumeration Date:2018-02-16
Last Update Date:2018-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX874409163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse