Provider Demographics
NPI:1104924240
Name:REYNA, LINDA LEAL (OTR)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:LEAL
Last Name:REYNA
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3522 QUEENSWAY DR
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78526-3711
Mailing Address - Country:US
Mailing Address - Phone:956-459-0563
Mailing Address - Fax:956-541-5486
Practice Address - Street 1:3522 QUEENSWAY DR
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78526-3711
Practice Address - Country:US
Practice Address - Phone:956-459-0563
Practice Address - Fax:956-541-5486
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX101349225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist