Provider Demographics
NPI:1861204562
Name:REYES, EMMA LUISA (LVN)
Entity type:Individual
Prefix:
First Name:EMMA
Middle Name:LUISA
Last Name:REYES
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14618 HIGHLAND RDG
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78233-3840
Mailing Address - Country:US
Mailing Address - Phone:830-513-3439
Mailing Address - Fax:
Practice Address - Street 1:16019 NACOGDOCHES RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78247-1128
Practice Address - Country:US
Practice Address - Phone:210-617-5300
Practice Address - Fax:210-443-0324
Is Sole Proprietor?:No
Enumeration Date:2025-01-21
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX198869164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse