Provider Demographics
NPI:1386041846
Name:REYNALDO T TOLENTINO MD PLLC
Entity Type:Organization
Organization Name:REYNALDO T TOLENTINO MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE OWNER/MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:REYNALDO
Authorized Official - Middle Name:T
Authorized Official - Last Name:TOLENTINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:940-552-6800
Mailing Address - Street 1:4301 COLLEGE DR
Mailing Address - Street 2:RM 500
Mailing Address - City:VERNON
Mailing Address - State:TX
Mailing Address - Zip Code:76384-3128
Mailing Address - Country:US
Mailing Address - Phone:940-552-6800
Mailing Address - Fax:940-552-6802
Practice Address - Street 1:4301 COLLEGE DR
Practice Address - Street 2:RM 500
Practice Address - City:VERNON
Practice Address - State:TX
Practice Address - Zip Code:76384-3128
Practice Address - Country:US
Practice Address - Phone:940-552-6800
Practice Address - Fax:940-552-6802
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-29
Last Update Date:2014-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty