Provider Demographics
NPI:1780230037
Name:REYES, PATRICIA (NP)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MRS
Other - First Name:PATTY
Other - Middle Name:
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:3701 LOCKE LN
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78415-3922
Mailing Address - Country:US
Mailing Address - Phone:361-331-1911
Mailing Address - Fax:
Practice Address - Street 1:5950 SARATOGA BLVD
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4100
Practice Address - Country:US
Practice Address - Phone:361-985-5811
Practice Address - Fax:361-985-5645
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-13
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142562363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty