Provider Demographics
NPI:1861016248
Name:TEIXEIRA DE ABREU REIS, PHILLIPE GERALDO (MD)
Entity Type:Individual
Prefix:MR
First Name:PHILLIPE
Middle Name:GERALDO
Last Name:TEIXEIRA DE ABREU REIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1635 AURORA CT
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80045-2541
Practice Address - Country:US
Practice Address - Phone:720-901-5233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2024-04-15
Deactivation Date:2022-01-18
Deactivation Code:
Reactivation Date:2022-03-01
Provider Licenses
StateLicense IDTaxonomies
FLME159540204F00000X
CODR.0073192204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery