Provider Demographics
NPI:1811294192
Name:REYES, YVONNE (OTR)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:813 VALLEY TRACE DR
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-4124
Mailing Address - Country:US
Mailing Address - Phone:956-532-6602
Mailing Address - Fax:
Practice Address - Street 1:1210 W EXPRESSWAY 83
Practice Address - Street 2:STE. 7
Practice Address - City:PHARR
Practice Address - State:TX
Practice Address - Zip Code:78577-6516
Practice Address - Country:US
Practice Address - Phone:956-783-9000
Practice Address - Fax:956-783-9131
Is Sole Proprietor?:No
Enumeration Date:2011-02-22
Last Update Date:2011-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX114030225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist