Provider Demographics
NPI:1982893780
Name:BRAID, REYNA MARIA (PAC)
Entity type:Individual
Prefix:MRS
First Name:REYNA
Middle Name:MARIA
Last Name:BRAID
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1570 LOMALAND DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-4224
Mailing Address - Country:US
Mailing Address - Phone:915-590-4555
Mailing Address - Fax:915-590-4718
Practice Address - Street 1:1570 LOMALAND DR
Practice Address - Street 2:SUITE A
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-4224
Practice Address - Country:US
Practice Address - Phone:915-590-4555
Practice Address - Fax:915-590-4718
Is Sole Proprietor?:No
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXPA00531363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical