Provider Demographics
NPI:1891863247
Name:REINOSO, MANUEL ADOLFO (MD)
Entity Type:Individual
Prefix:DR
First Name:MANUEL
Middle Name:ADOLFO
Last Name:REINOSO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1400 E RIDGE RD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78503-1535
Mailing Address - Country:US
Mailing Address - Phone:956-928-0400
Mailing Address - Fax:800-928-0537
Practice Address - Street 1:1400 E RIDGE RD
Practice Address - Street 2:SUITE 7
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78503-1535
Practice Address - Country:US
Practice Address - Phone:956-928-0400
Practice Address - Fax:800-928-0537
Is Sole Proprietor?:No
Enumeration Date:2006-12-02
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK25702080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX037774903Medicaid
TX037774903Medicaid