Provider Demographics
NPI:1972770089
Name:REYES, NOE (MA, CCC/SLP)
Entity type:Individual
Prefix:MR
First Name:NOE
Middle Name:
Last Name:REYES
Suffix:
Gender:M
Credentials:MA, CCC/SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 473
Mailing Address - Street 2:2509 BRAZIL ST
Mailing Address - City:HIDALGO
Mailing Address - State:TX
Mailing Address - Zip Code:78557-0473
Mailing Address - Country:US
Mailing Address - Phone:956-843-5044
Mailing Address - Fax:956-618-2296
Practice Address - Street 1:4004 N JACKSON RD
Practice Address - Street 2:
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-4962
Practice Address - Country:US
Practice Address - Phone:956-618-2287
Practice Address - Fax:956-618-2296
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-08
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX100432235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist