Provider Demographics
NPI:1851411045
Name:REYES, ARIEL (LPT)
Entity Type:Individual
Prefix:
First Name:ARIEL
Middle Name:
Last Name:REYES
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 MURCHISON DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-2921
Mailing Address - Country:US
Mailing Address - Phone:915-533-7465
Mailing Address - Fax:915-534-1289
Practice Address - Street 1:9999 KENWORTHY ST
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-4412
Practice Address - Country:US
Practice Address - Phone:915-759-7757
Practice Address - Fax:915-751-7554
Is Sole Proprietor?:No
Enumeration Date:2007-03-30
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1079374225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist