Jacqueline Vanessa Reyes Diaz, MD

Primary specialty

Pediatric Endocrinology PhysicianTaxonomy code 2080P0205X

License

T2737 Issued in TX

Practice address

3533 S Alameda St Apt 532
Corpus Christi, TX 78411-1721

Phone

(361) 694-4864

Fax

(361) 851-6867

NPI assigned

Jul 15, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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

• Children'S Physician Services of South Texas

  • Plastic Surgery Physician
  • Corpus Christi, TX
  • NPI 1568658227
  Medicare reassignment
• Children'S Physician Services of South Texas

  • Diagnostic Radiology Physician
  • Corpus Christi, TX
  • NPI 1598737124
  NPD (past)

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

{
    "created_epoch": "1405382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1962819573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3533 S ALAMEDA ST",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784111721",
            "telephone_number": "631-575-4180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3533 S ALAMEDA ST APT 532",
            "city": "CORPUS CHRISTI",
            "state": "TX",
            "postal_code": "784111721",
            "telephone_number": "361-694-4864",
            "fax_number": "361-851-6867"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2015 Uppergate Drive NE Rm.534",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "30322",
            "country_code": "US",
            "telephone_number": "631-575-4180",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2201 Hempstead Tpke",
            "address_purpose": "LOCATION",
            "city": "East Meadow",
            "state": "NY",
            "postal_code": "115541859",
            "country_code": "US",
            "telephone_number": "516-572-6177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "REYES DIAZ",
        "first_name": "JACQUELINE VANESSA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-15",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": "080216",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2080P0205X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Endocrinology",
            "state": "TX",
            "license": "T2737",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Resurgence Therapy PLLC
• Retina Physicians of Corpus Christi, P.a.
• Retina Specialists, P.a.
• Amisha Revawala
• Revive Infusion & Wellness, LLC
• Celia Reyes-Acuna, M.D.
• Allison Reyes
• Cruz Ariana Reyes, AUD
• Erasmo Adrian Reyes, M.D.
• Estella Guerra Reyes, LVN

• Pediatric Endocrinology Physician in Corpus Christi, TX
• Providers in Corpus Christi, TX by specialty
• Pediatric Endocrinology Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.