Provider Demographics
NPI:1972899284
Name:REYES FAMILY MEDICINE, PLC
Entity Type:Organization
Organization Name:REYES FAMILY MEDICINE, PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:L
Authorized Official - Last Name:REYES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-209-1778
Mailing Address - Street 1:926 E. MCDOWELL RD.
Mailing Address - Street 2:SUITE 125
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85006-2521
Mailing Address - Country:US
Mailing Address - Phone:602-466-2769
Mailing Address - Fax:602-626-5112
Practice Address - Street 1:926 E. MCDOWELL RD.
Practice Address - Street 2:SUITE 125
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2521
Practice Address - Country:US
Practice Address - Phone:602-466-2769
Practice Address - Fax:602-626-5112
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-24
Last Update Date:2017-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care