Provider Demographics
NPI:1417916594
Name:REYES, JOEL A (DO)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:A
Last Name:REYES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:4845 ALAMEDA AVE
Mailing Address - Street 2:PEDIATRIC ICU - 10TH FLOOR
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2705
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4845 ALAMEDA AVE
Practice Address - Street 2:PEDIATRIC ICU - 10TH FLOOR
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79905-2705
Practice Address - Country:US
Practice Address - Phone:915-298-5431
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-19
Last Update Date:2016-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101016314208000000X
TXM63592080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics