Doctor Name: | JAMIE LYNN REYNA |
NPI Number: | 1063763225 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PAC |
License Number: | |
Business Practice Address: | 3801 Scott And White Dr Killeen, TX - 765435252 |
Business Phone Number: | 2546801100 |
Business Fax Number: | |
Mailing Address: | Po Box 847408, DALLAS |
State: | TX |
Postal Code: | 752847480 |
Phone Number: | 2547248800 |
Fax Number: | |
NPI Enumeration Date: | 09/27/2012 |
NPI Last Update Date: | 02/25/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |