Provider Demographics
NPI:1336816925
Name:REYES, ALICIA GREGORIOS
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:GREGORIOS
Last Name:REYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4609 WORCHESTER LN
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-2666
Mailing Address - Country:US
Mailing Address - Phone:843-597-6564
Mailing Address - Fax:
Practice Address - Street 1:4609 WORCHESTER LN
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-2666
Practice Address - Country:US
Practice Address - Phone:843-597-6564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-23
Last Update Date:2021-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care