Diaz-Reyes, Gustavo

Diaz-Reyes, Gustavo is an individual health care provider with primary practice located at 4100 Everett Dr Suite 400, Kyle TX 78640-6146. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Diaz-Reyes, Gustavo can be contacted via phone (512) 295-1333.

Contact Information

Primary practice address
4100 Everett Dr Suite 400 Kyle TX 78640-6146
Phone: (512) 295-1333
Fax: (512) 406-7327
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X 234797 New York
Allopathic & Osteopathic Physicians / Otolaryngology 207Y00000X Q9332 Texas

Profile Details

NPI number 1588652168
LBN Legal business name Diaz-Reyes, Gustavo
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 8th, 2005
Last updated Jun 11th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588652168 NPPES
Texas MEDICAID 364332202
Texas MEDICAID 02634339
Texas MEDICAID 364332201

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