Individual
STEVEN REILLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1729 WESTON BRENT LN STE A, EL PASO, TX 79935-3013
(915) 595-1905
(915) 595-1934
Mailing address
11364B BEACH FRONT DR, EL PASO, TX 79936-3806
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA02136
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA02136
STATE LICENSE
TX
Enumeration date
12/27/2006
Last updated
07/08/2007
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