Provider Demographics
NPI:1780197079
Name:REYES, HECTOR III (DC)
Entity Type:Individual
Prefix:DR
First Name:HECTOR
Middle Name:
Last Name:REYES
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 SUNSET ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2668
Mailing Address - Country:US
Mailing Address - Phone:940-383-9399
Mailing Address - Fax:940-566-8630
Practice Address - Street 1:707 SUNSET ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2668
Practice Address - Country:US
Practice Address - Phone:940-383-9399
Practice Address - Fax:940-566-8630
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX140823111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX140823OtherSTATE LICENSE