Provider Demographics
NPI:1609051523
Name:CARPINTEYRO-REYES, ROSE (RN)
Entity Type:Individual
Prefix:MS
First Name:ROSE
Middle Name:
Last Name:CARPINTEYRO-REYES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:ROSE
Other - Middle Name:
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:3522 FOXBRIAR LN
Mailing Address - Street 2:
Mailing Address - City:CIBOLO
Mailing Address - State:TX
Mailing Address - Zip Code:78108-2234
Mailing Address - Country:US
Mailing Address - Phone:830-606-1093
Mailing Address - Fax:830-606-9608
Practice Address - Street 1:3522 FOXBRIAR LN
Practice Address - Street 2:
Practice Address - City:CIBOLO
Practice Address - State:TX
Practice Address - Zip Code:78108-2234
Practice Address - Country:US
Practice Address - Phone:830-606-1093
Practice Address - Fax:830-606-9608
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-09
Last Update Date:2008-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX245295163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1004759Medicaid