Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | AP137722 | TX |
Y | 363L00000X | Nurse Practitioner | AP137722 | TX |
NPI | 1518631969 |
---|---|
Provider Name | Belinda Pena |
First Address | San Antonio, TX 78229-3901 |
Second Address | San Antonio, TX 78229-3931 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2021 |
Last Update Date | 12/08/2021 |