Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | AP136959 | TX |
NPI | 1194226753 |
---|---|
Provider Name | Mrs. Renee Dawn Resendez |
First Address | Dallas, TX 75284-8491 |
Second Address | Waco, TX 76712 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2018 |
Last Update Date | 28/01/2022 |