Basic Information
| Provider Information | |||||||||
| NPI: | 1164496220 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | REYES | ||||||||
| FirstName: | RUBEN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2330 SHAWNEE MISSION PKWY | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | WESTWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662052005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135886029 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2330 SHAWNEE MISSION PKWY | ||||||||
| Address2: | SUITE 210 | ||||||||
| City: | WESTWOOD | ||||||||
| State: | KS | ||||||||
| PostalCode: | 662052005 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9135886029 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/15/2006 | ||||||||
| LastUpdateDate: | 06/17/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2006-01666 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 789683 | 01 | MVP HEALTH CARE | OTHER | 7977717 | 01 | AETNA US HEALTHCARE | OTHER | 92443 | 01 | FALLON COMMUNITY HEALTH P | OTHER | 0408351 | 01 | EVERCARE | OTHER | 042472266 | 01 | UNITED HEALTHCARE | OTHER | 87425 | 01 | HEALTHY START | OTHER | J28914 | 01 | BLUE SHIELD HMO BLUE | OTHER | 042472266 | 01 | PRIVATE HEALTHCARE SYSTEM | OTHER | 4613180 | 01 | CIGNA HEALTH PLAN | OTHER | 466559 | 01 | TUFTS HEALTH PLAN | OTHER | 87425 | 01 | CHILDRENS MEDICAL SECURIT | OTHER | 2103966 | 01 | MEDICAID WELFARE | OTHER | AA37371 | 01 | HARVARD PILGRIM HEALTHCAR | OTHER | J28914 | 01 | BLUE CARE ELECT | OTHER | 042472266 | 01 | ONE HEALTH PLAN | OTHER | 2103966 | 05 | MA | MEDICAID | P00253383 | 01 | RAILROAD MEDICARE | OTHER |