Provider Demographics
NPI:1568994747
Name:REYES, MARIA GRACIELA QUINTOS (PT)
Entity Type:Individual
Prefix:
First Name:MARIA GRACIELA
Middle Name:QUINTOS
Last Name:REYES
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 749
Mailing Address - Street 2:
Mailing Address - City:PHARR
Mailing Address - State:TX
Mailing Address - Zip Code:78577-1614
Mailing Address - Country:US
Mailing Address - Phone:956-362-3960
Mailing Address - Fax:956-362-3965
Practice Address - Street 1:131 N FM 3167 STE B
Practice Address - Street 2:
Practice Address - City:RIO GRANDE CITY
Practice Address - State:TX
Practice Address - Zip Code:78582-7009
Practice Address - Country:US
Practice Address - Phone:956-362-3960
Practice Address - Fax:956-362-3965
Is Sole Proprietor?:No
Enumeration Date:2017-03-28
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1277279225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist