Provider Demographics
NPI:1760152979
Name:REYES, ALEXANDER ANTONIO (PTA)
Entity type:Individual
Prefix:MR
First Name:ALEXANDER
Middle Name:ANTONIO
Last Name:REYES
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 BROADWAY ST APT 933
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-7827
Mailing Address - Country:US
Mailing Address - Phone:832-368-0316
Mailing Address - Fax:
Practice Address - Street 1:10000 BROADWAY ST APT 933
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-7827
Practice Address - Country:US
Practice Address - Phone:832-368-0316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-18
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2165244208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation