Provider Demographics
NPI:1194046912
Name:SUAREZ-REYNA, ROSA CORINA (OD)
Entity type:Individual
Prefix:DR
First Name:ROSA
Middle Name:CORINA
Last Name:SUAREZ-REYNA
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:6450 NW LOOP 410
Mailing Address - Street 2:STE 115
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78238-4210
Mailing Address - Country:US
Mailing Address - Phone:210-691-4733
Mailing Address - Fax:210-647-4741
Practice Address - Street 1:6450 NW LOOP 410 STE 115
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78238-4210
Practice Address - Country:US
Practice Address - Phone:210-521-2085
Practice Address - Fax:210-509-0962
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6958TG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist