Individual
MAIDEL REINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1808 S FAROLA DR, DALLAS, TX 75228-2541
(214) 451-7987
Mailing address
340 EL RIO DR, MESQUITE, TX 75150-3100
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
895663
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
163W00000X
TAXONOMY
—
Enumeration date
04/10/2018
Last updated
06/11/2019
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