Provider Demographics
NPI:1780210492
Name:REYES, ELYZABETH (FNP-C)
Entity type:Individual
Prefix:
First Name:ELYZABETH
Middle Name:
Last Name:REYES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3312 N BUCKNER BLVD STE 213
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75228-5642
Mailing Address - Country:US
Mailing Address - Phone:469-998-0720
Mailing Address - Fax:
Practice Address - Street 1:3312 N BUCKNER BLVD STE 213
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75228-5642
Practice Address - Country:US
Practice Address - Phone:469-998-0720
Practice Address - Fax:877-692-4919
Is Sole Proprietor?:No
Enumeration Date:2020-03-14
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145542363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily