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Individual
MR. SERGIO REYES JR.
Active
Individual
MR. SERGIO REYES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA08555
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
356067401
—
TX
01
—
482475YLPS
WELLMED PTAN
TX
Enumeration date
07/22/2013
Last updated
06/15/2016
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