Provider Demographics
NPI:1376043547
Name:PEREZ, REYNALDA L (LVN)
Entity Type:Individual
Prefix:MRS
First Name:REYNALDA
Middle Name:L
Last Name:PEREZ
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 VANDERBILT ST
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78210-5246
Mailing Address - Country:US
Mailing Address - Phone:210-896-7959
Mailing Address - Fax:
Practice Address - Street 1:906 VANDERBILT ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78210-5246
Practice Address - Country:US
Practice Address - Phone:210-896-7959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-14
Last Update Date:2018-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX165930164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse