Provider Demographics
NPI:1003095316
Name:REILLY, YVETTE M (RNFA)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:M
Last Name:REILLY
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 COMMERCIAL CENTER BLVD
Mailing Address - Street 2:SUITE 103129
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-6583
Mailing Address - Country:US
Mailing Address - Phone:713-703-2823
Mailing Address - Fax:888-329-6432
Practice Address - Street 1:2910 COMMERCIAL CENTER BLVD
Practice Address - Street 2:SUITE 103129
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-6583
Practice Address - Country:US
Practice Address - Phone:713-703-2823
Practice Address - Fax:888-329-6432
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-02
Last Update Date:2007-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX542393163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant