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Individual

DAG ROSS MAHINAY REYES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3001 BROADMOOR BLVD NE, RIO RANCHO, NM 87144-2100
(505) 308-3145
Mailing address
1304 TAMINA PASS LN, FRIENDSWOOD, TX 77546-2040

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
75131
NM
367500000X
Certified Registered Nurse Anesthetist
754579
TX

Other

Enumeration date
01/31/2014
Last updated
01/25/2024
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