Provider Demographics
NPI:1255608097
Name:CELIA REYES-ACUNA, MD PLLC
Entity type:Organization
Organization Name:CELIA REYES-ACUNA, MD PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CELIA
Authorized Official - Middle Name:D
Authorized Official - Last Name:REYES-ACUNA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:361-991-4040
Mailing Address - Street 1:4444 S STAPLES ST
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-2602
Mailing Address - Country:US
Mailing Address - Phone:361-991-4040
Mailing Address - Fax:361-985-2717
Practice Address - Street 1:4444 S STAPLES ST
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-2602
Practice Address - Country:US
Practice Address - Phone:361-991-4040
Practice Address - Fax:361-985-2717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-22
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE8268208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX126172905Medicaid
TX126172904Medicaid
TXC21012Medicare UPIN