Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | 1671 | TX |
N | 222Z00000X | Podiatrist | 1671 | TX |
Y | 224P00000X | Prosthetist | 1671 | TX |
NPI | 1174890404 |
---|---|
Provider Name | Rick Rentfrow |
First Address | Corpus Christi, TX 78418 |
Second Address | Corpus Christi, TX 78412-4929 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/12/2011 |
Last Update Date | 15/08/2017 |