Provider Demographics
NPI:1609566405
Name:REYES, MARILOU ZUNIGA (APRN)
Entity Type:Individual
Prefix:
First Name:MARILOU
Middle Name:ZUNIGA
Last Name:REYES
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6602 ROSEMARY KNOLL LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-1246
Mailing Address - Country:US
Mailing Address - Phone:773-814-4677
Mailing Address - Fax:
Practice Address - Street 1:6602 ROSEMARY KNOLL LN
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-1246
Practice Address - Country:US
Practice Address - Phone:773-814-4677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-15
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1119124363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care