Provider Demographics
NPI:1811884265
Name:SOTO REYES, ANDRES (FNP)
Entity type:Individual
Prefix:
First Name:ANDRES
Middle Name:
Last Name:SOTO REYES
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1211 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:TEMPLE
Mailing Address - State:TX
Mailing Address - Zip Code:76504-5926
Mailing Address - Country:US
Mailing Address - Phone:254-541-5861
Mailing Address - Fax:
Practice Address - Street 1:1005 MARLANDWOOD RD STE 102
Practice Address - Street 2:
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76502-3331
Practice Address - Country:US
Practice Address - Phone:866-935-9283
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-19
Last Update Date:2025-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1204789363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care