Individual provider Active NPI

Leticia S. Reyna, M.T.

  • Clinical Medical Laboratory
  • El Paso, TX
National Provider Identifier
1760623532
Registry record updated Mar 9, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
45D0509686 Issued in TX
Practice address
4900 Alameda Ave
Suite E
El Paso, TX 79905-2802
Phone
(915) 772-1768
Fax
(915) 772-1768
NPI assigned
Mar 9, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 9, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X 45D0509686 TX Primary

Addresses

Primary practice location

4900 Alameda Ave
Suite E
El Paso, TX 79905-2802

Mailing address

4900 Alameda Ave
Suite E
El Paso, TX 79905-2802
Phone (915) 772-1768

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Medical Technician

State licenses

LicenseStateTypeSpecialty
45D0509686TXMDClinical Medical Laboratory

NPI Registry JSON

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

{
    "created_epoch": "1236556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1236556800000",
    "number": "1760623532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4900 ALAMEDA AVE",
            "address_2": "SUITE E",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052802",
            "telephone_number": "915-772-1768",
            "fax_number": "915-772-1768"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4900 ALAMEDA AVE",
            "address_2": "SUITE E",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799052802",
            "telephone_number": "915-772-1768",
            "fax_number": "915-772-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REYNA",
        "first_name": "LETICIA",
        "middle_name": "S.",
        "credential": "M.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-09",
        "last_updated": "2009-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "TX",
            "license": "45D0509686",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2009; 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.