Individual
CHRISTIAN RENAE LONGORIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N., F.N.P.
Contact information
Practice address
555 E BASSE RD STE 117, SAN ANTONIO, TX 78209-8329
(210) 546-1430
(210) 546-1439
Mailing address
45 NE LOOP 410, STE 850, SAN ANTONIO, TX 78216-5824
(210) 805-9800
(210) 805-8770
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
606979
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2854499-01
—
TX
01
—
8G8269
MEDICARE PTAN
TX
Enumeration date
08/21/2006
Last updated
06/02/2020
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