Individual
ALEXANDER PENARANDA BALONGOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
230 SHEPHERD HL, CANYON LAKE, TX 78133-5606
(210) 332-2160
Mailing address
819 WATER ST STE 300, KERRVILLE, TX 78028-5330
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP144436
TX
Other
Enumeration date
01/27/2020
Last updated
01/27/2020
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