Provider Demographics
NPI:1407045701
Name:MAURICIO A REINOSO
Entity Type:Organization
Organization Name:MAURICIO A REINOSO
Other - Org Name:SOUTHWEST PULMONARY AND SLEEP DISORDERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:MS
Authorized Official - First Name:KOKO
Authorized Official - Middle Name:
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-980-1330
Mailing Address - Street 1:16605 SOUTHWEST FWY
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-3501
Mailing Address - Country:US
Mailing Address - Phone:281-980-1330
Mailing Address - Fax:281-980-1331
Practice Address - Street 1:16605 SOUTHWEST FWY
Practice Address - Street 2:SUITE 310
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-3501
Practice Address - Country:US
Practice Address - Phone:281-980-1330
Practice Address - Fax:281-980-1331
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-23
Last Update Date:2011-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ5877207RC0200X, 207RP1001X, 207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00X602Medicare PIN