Provider Demographics
NPI:1295711166
Name:TORRES-REYES, LAURA (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:LAURA
Middle Name:
Last Name:TORRES-REYES
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1917 RED ROBIN DR N
Mailing Address - Street 2:
Mailing Address - City:XENIA
Mailing Address - State:OH
Mailing Address - Zip Code:45385-9914
Mailing Address - Country:US
Mailing Address - Phone:301-412-5280
Mailing Address - Fax:
Practice Address - Street 1:2510 5TH ST BLDG 840
Practice Address - Street 2:
Practice Address - City:WRIGHT PATTERSON AFB
Practice Address - State:OH
Practice Address - Zip Code:45433-7951
Practice Address - Country:US
Practice Address - Phone:937-938-3084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2015-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA58429171000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171000000XOther Service ProvidersMilitary Health Care Provider