Provider Demographics
NPI:1962571174
Name:REYES, SONIA H (MSN, FNP)
Entity type:Individual
Prefix:
First Name:SONIA
Middle Name:H
Last Name:REYES
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2702 NOTTINGHAM LN
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-6436
Mailing Address - Country:US
Mailing Address - Phone:510-684-2769
Mailing Address - Fax:
Practice Address - Street 1:2702 NOTTINGHAM LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-6436
Practice Address - Country:US
Practice Address - Phone:510-684-2769
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX734030363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner