Matthew Victor Reza, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

247228 Issued in AZ

Practice address

6520 Eagle Ridge Dr
El Paso, TX 79912-7435

Phone

(915) 260-1059

NPI assigned

Nov 4, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707696000000",
    "number": "1124629209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6520 EAGLE RIDGE DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799127435",
            "telephone_number": "915-260-1059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6520 EAGLE RIDGE DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799127435",
            "telephone_number": "915-260-1059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2090 Columbiana Rd",
            "address_purpose": "LOCATION",
            "city": "Vestavia Hills",
            "state": "AL",
            "postal_code": "352162153",
            "country_code": "US",
            "telephone_number": "205-406-2263",
            "fax_number": "205-545-9562",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REZA",
        "first_name": "MATTHEW",
        "middle_name": "VICTOR",
        "name_prefix": "Dr.",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-11-04",
        "last_updated": "2024-02-12",
        "certification_date": "2024-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "AZ",
            "license": "247228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John William Reynolds, DDS
• Richard Dale Reynolds, MD
• Roberto Reynoso Figueroa, MD
• Eduardo Aron Reza-Romo
• Edwin Saul Reza
• Somaye Rezaei, MD
• Aleksandr A Reznichenko, MD
• RG Hardaway, Inc.
• Rgasc, LLC.
• RGTG, LLC

• Psychiatric/Mental Health Nurse Practitioner in El Paso, TX
• Providers in El Paso, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.