Individual
VICTORIA REYNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8731 PARK PLAZA DR, SHREVEPORT, LA 71105-5682
(318) 797-5848
(318) 797-5844
Mailing address
8731 PARK PLAZA DR, SHREVEPORT, LA 71105-5682
(318) 797-5848
(318) 797-5844
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
343023
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16302840
CAQH
—
Enumeration date
05/07/2024
Last updated
04/21/2025
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