Andrew Amadeus De Los Reyes, IDMT

Primary specialty

Independent Duty Medical TechniciansTaxonomy code 1710I1003X

Practice address

271 Fort Richardson Ave BLDG 1001
Goodfellow Afb, TX 76908-4901

Phone

(325) 654-1484

NPI assigned

Sep 19, 2018

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

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

{
    "created_epoch": "1537315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537315200000",
    "number": "1821572561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3488 GARDEN AVE",
            "address_2": "MIF 4",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "78234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "271 FORT RICHARDSON AVE BLDG 1001",
            "city": "GOODFELLOW AFB",
            "state": "TX",
            "postal_code": "769084901",
            "telephone_number": "325-654-1484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LOS REYES",
        "first_name": "ANDREW",
        "middle_name": "AMADEUS",
        "credential": "IDMT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-19",
        "last_updated": "2018-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1003X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Medical Technicians",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pedro Colon
• Kristen Cooper, LCSW
• Kelly Erin Corbit, M-PAS, PA-C
• Mindy Courter, LCSW
• Michael Roy De Jesus, DNP, APRN, FNP-C
• Lindsay Elisha Denton, O.D.
• Warren Dial, PA
• Amanda Michele Durbin, MA
• Sonia B Flick, LCSW-S, MCAP
• Micah Aston Ford, PA-C

• Independent Duty Medical Technicians in Goodfellow Afb, TX
• Providers in Goodfellow Afb, TX by specialty
• Independent Duty Medical Technicians in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2018; 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.