Provider Demographics
NPI:1841722808
Name:REYES, KARLA MELISSA (RDN, LD)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:MELISSA
Last Name:REYES
Suffix:
Gender:F
Credentials:RDN, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8711 VILLAGE DR
Mailing Address - Street 2:SUITE 114
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78217-5418
Mailing Address - Country:US
Mailing Address - Phone:210-228-9605
Mailing Address - Fax:210-228-9632
Practice Address - Street 1:311 CAMDEN ST
Practice Address - Street 2:SUITE 409
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78215-2012
Practice Address - Country:US
Practice Address - Phone:210-228-9605
Practice Address - Fax:210-228-9632
Is Sole Proprietor?:No
Enumeration Date:2017-03-29
Last Update Date:2017-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT83852133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered