Octavio Reyna, PT,DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

LPT-034330 Issued in AZ

Practice address

1453 N. Main Street
San Luis, AZ 85349

Phone

(928) 722-6050

Fax

(928) 722-6094

NPI assigned

Sep 22, 2026

Last updated

Sep 22, 2026By the provider in NPPES

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

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

{
    "created_epoch": "1790035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790035200000",
    "number": "1679485742",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1453 N. MAIN STREET",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "85349",
            "telephone_number": "928-722-6050",
            "fax_number": "928-722-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 N. MAIN STREET",
            "city": "SAN LUIS",
            "state": "AZ",
            "postal_code": "85349",
            "telephone_number": "928-722-6050",
            "fax_number": "928-722-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNA",
        "first_name": "OCTAVIO",
        "name_prefix": "Dr.",
        "credential": "PT,DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-22",
        "last_updated": "2026-09-22",
        "certification_date": "2026-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "LPT-034330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in San Luis, AZ
• Providers in San Luis, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.