Provider Demographics
NPI:1770283525
Name:REYES, JOSUE ERNESTO (BSN-RN)
Entity type:Individual
Prefix:
First Name:JOSUE
Middle Name:ERNESTO
Last Name:REYES
Suffix:
Gender:M
Credentials:BSN-RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11415 SAGEWHITE DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77089-4207
Mailing Address - Country:US
Mailing Address - Phone:713-922-5689
Mailing Address - Fax:
Practice Address - Street 1:11415 SAGEWHITE DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77089-4207
Practice Address - Country:US
Practice Address - Phone:713-922-5689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1020987163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse