# DEOGRACIAS R PENA

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1669483855
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2080P0210X | Pediatric Nephrology Physician | J9778 | TX | — |
| 2080P0210X | Pediatric Nephrology Physician | ME56326 | FL | Yes |

## Other

- **Enumeration date:** 08/11/2006
- **Last updated:** 09/06/2014

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 00U87Z | BCBSTX GRP PIN | TX |
| 01 | — | 10010075 | AMERIGROUP PIN | TX |
| 01 | — | 109517 | SUPERIOR PIN | TX |
| 01 | — | 121266102 | FIRSTCARE PIN | TX |
| 05 | — | 133426012 | — | TX |
| 01 | — | 1443501 | UHC PIN | TX |
| 01 | — | 1750369203 | GRP NPI NUMBER | — |
| 01 | — | 5056081 | AETNA PIN | TX |
| 01 | — | 75208965 | CIGNA PIN | TX |
| 01 | — | 87Y112 | BCBSTX PIN | TX |