Provider Demographics
NPI:1346375375
Name:REYES, LISA RENEE (FNP)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:RENEE
Last Name:REYES
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6901 BERTNER AVE FL 8
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3901
Mailing Address - Country:US
Mailing Address - Phone:713-344-2405
Mailing Address - Fax:713-344-9420
Practice Address - Street 1:7000 FANNIN ST
Practice Address - Street 2:STE. 1620
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-5400
Practice Address - Country:US
Practice Address - Phone:713-500-3267
Practice Address - Fax:713-500-3263
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX558719163W00000X
TX2006005547-22363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily