Provider Demographics
NPI:1053132266
Name:ZETAK-REYES, ELIZABETH DAWN (FNP-C)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:DAWN
Last Name:ZETAK-REYES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:30719 LEGENDS RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77386-3901
Mailing Address - Country:US
Mailing Address - Phone:832-616-0104
Mailing Address - Fax:
Practice Address - Street 1:8201 CYPRESSWOOD DR STE 101
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-7587
Practice Address - Country:US
Practice Address - Phone:713-527-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1179583207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine