Provider Demographics
NPI:1972833085
Name:REYENGA, AUDREY HELEN (PA)
Entity type:Individual
Prefix:MRS
First Name:AUDREY
Middle Name:HELEN
Last Name:REYENGA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3460 N. DOWLEN RD
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-1690
Mailing Address - Country:US
Mailing Address - Phone:409-838-0346
Mailing Address - Fax:409-839-3710
Practice Address - Street 1:3460 N. DOWLEN RD
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77706-1690
Practice Address - Country:US
Practice Address - Phone:409-838-0346
Practice Address - Fax:409-839-3710
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA06635363AS0400X
363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical