Provider Demographics
NPI:1740007665
Name:REED, IRYONNA ANDREA
Entity type:Individual
Prefix:
First Name:IRYONNA
Middle Name:ANDREA
Last Name:REED
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 1:1970 BELLA LOMA DR
Mailing Address - Street 2:9-304
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78256
Mailing Address - Country:US
Mailing Address - Phone:210-540-7174
Mailing Address - Fax:
Practice Address - Street 1:8700 POST OAK LN
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78217-5170
Practice Address - Country:US
Practice Address - Phone:210-775-0869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-23
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2185354225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant