Provider Demographics
NPI:1316143621
Name:REYNA, TANIA ALEJANDRA (MD)
Entity type:Individual
Prefix:
First Name:TANIA
Middle Name:ALEJANDRA
Last Name:REYNA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1145 S UTICA AVE STE 110
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-4013
Mailing Address - Country:US
Mailing Address - Phone:918-579-3825
Mailing Address - Fax:918-579-1262
Practice Address - Street 1:9001 S 101ST EAST AVE STE 190
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-5799
Practice Address - Country:US
Practice Address - Phone:918-579-3870
Practice Address - Fax:918-550-6736
Is Sole Proprietor?:No
Enumeration Date:2007-06-23
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK256242084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology