Individual
ANITA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LVN
Contact information
Practice address
5046 BENHAM DR, SAN ANTONIO, TX 78220-4920
(512) 815-9911
Mailing address
5046 BENHAM DR, SAN ANTONIO, TX 78220-4920
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
208503
TX
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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