Individual provider Active NPI

Reynaldo Daba II, ACNP-BC

  • Acute Care Nurse Practitioner
  • Dallas, TX
National Provider Identifier
1184167561
Registry record updated Mar 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
AP132507 Issued in TX
Practice address
221 W Colorado Blvd Ste 525
Dallas, TX 75208-2312
Phone
(214) 960-5681
Fax
(214) 960-5681
NPI assigned
Dec 2, 2016
Last updated
Mar 18, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X AP132507 TX Primary

Addresses

Primary practice location

221 W Colorado Blvd Ste 525
Dallas, TX 75208-2312

Mailing address

221 W Colorado Blvd Ste 525
Dallas, TX 75208-2312
Phone (214) 960-5681

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171211001757 TX Practitioner - Nurse Practitioner 3476811910 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Laredo ICU LLCGroup PAC ID 7618324898, 27 clinicians
Dallas Pulmonary and Critical Care PAGroup PAC ID 2163679200, 186 clinicians

Practice addresses (Care Compare)

1700 E Saunders St
Laredo, TX 78041-5474
Phone (956) 796-4658

221 W Colorado Blvd
Suite 525
Dallas, TX 75208-2312
Phone 214960568175

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Dallas Pulmonary & Critical Care PA Acute Care CurrentSince Jun 9, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Aug 6, 2018 Accepting new patients
Hunt Memorial Hospital District CurrentSince Dec 1, 2024 Accepting new patients
Hunt Memorial Hospital District CurrentSince Dec 1, 2024 Accepting new patients
Intensivist Medicine Services of TX, PLLC CurrentSince Aug 1, 2023 Accepting new patients
Christus Trinity Clinic Texas CurrentSince Aug 6, 2018 Accepting new patients

Locations

100 E Alton Gloor Blvd
Brownsville, TX 78526
Phone (956) 350-7000

221 W Colorado Blvd
Ste 525
Dallas, TX 75208
Phone (214) 956-4525

4215 Ramsey Blvd E
Greenville, TX 75401
Phone (903) 408-1470

710 FM 1960 Rd W
Houston, TX 77090
Phone (281) 440-1000

5605 N MacArthur Blvd
Ste 740
Irving, TX 75038
Phone 2149605681 ext. 75

630 S Fleishel Ave
Tyler, TX 75701
Phone (903) 510-8888

800 E Dawson St
Tyler, TX 75701
Phone (903) 531-5018

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1480636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710720000000",
    "number": "1184167561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W COLORADO BLVD STE 525",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752082312",
            "telephone_number": "214-960-5681",
            "fax_number": "214-960-5681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W COLORADO BLVD STE 525",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752082312",
            "telephone_number": "214-960-5681",
            "fax_number": "214-960-5681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DABA",
        "first_name": "REYNALDO",
        "name_suffix": "II",
        "credential": "ACNP-BC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-12-02",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "AP132507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.