Provider Demographics
NPI:1629532403
Name:REYES, JOSHUA JAMES
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:JAMES
Last Name:REYES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5905 HARVEST HILL RD
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-3407
Mailing Address - Country:US
Mailing Address - Phone:361-728-2005
Mailing Address - Fax:
Practice Address - Street 1:5905 HARVEST HILL RD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-3407
Practice Address - Country:US
Practice Address - Phone:361-728-2005
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-25
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer