Provider Demographics
NPI:1760287486
Name:REYNA CRUZ, YANAI
Entity type:Individual
Prefix:
First Name:YANAI
Middle Name:
Last Name:REYNA CRUZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31426 KAILUA DR
Mailing Address - Street 2:
Mailing Address - City:HOCKLEY
Mailing Address - State:TX
Mailing Address - Zip Code:77447-1826
Mailing Address - Country:US
Mailing Address - Phone:786-474-1028
Mailing Address - Fax:
Practice Address - Street 1:5829 W SAM HOUSTON PKWY N STE 1109
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77041-4743
Practice Address - Country:US
Practice Address - Phone:713-815-9724
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-17
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX991205163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse