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Individual

GWENDOLYN G REYNA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
801 ENCINO PL NE, SUITE E-12, ALBUQUERQUE, NM 87102-2612
(505) 842-5151
Mailing address
5080 SPECTRUM DR, SUITE 1200 WEST, ADDISON, TX 75001-4648
(800) 232-3550

Taxonomy

Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
MD2007-0053
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01786342
NM
05
10231773
NM
05
28777841
NM
05
46650024
NM
05
51305879
NM
05
53938577
NM
Enumeration date
11/09/2007
Last updated
07/09/2009
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