Provider Demographics
NPI:1063206779
Name:REYES, DALIA MARIA
Entity type:Individual
Prefix:
First Name:DALIA
Middle Name:MARIA
Last Name:REYES
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 1:291 E STATE HIGHWAY 7
Mailing Address - Street 2:
Mailing Address - City:NACOGDOCHES
Mailing Address - State:TX
Mailing Address - Zip Code:75961-8910
Mailing Address - Country:US
Mailing Address - Phone:936-553-8662
Mailing Address - Fax:
Practice Address - Street 1:291 E STATE HIGHWAY 7
Practice Address - Street 2:
Practice Address - City:NACOGDOCHES
Practice Address - State:TX
Practice Address - Zip Code:75961-8910
Practice Address - Country:US
Practice Address - Phone:936-553-8662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXNWW-2119347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle