Provider Demographics
NPI:1205299492
Name:REYNA, ANGELINA L (PA)
Entity type:Individual
Prefix:MS
First Name:ANGELINA
Middle Name:L
Last Name:REYNA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3809 W BUSINESS 83
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-3521
Mailing Address - Country:US
Mailing Address - Phone:956-364-0325
Mailing Address - Fax:
Practice Address - Street 1:3809 W BUSINESS 83
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78552-3521
Practice Address - Country:US
Practice Address - Phone:956-364-0325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA10420363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant