Individual
JIMMY L PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, CPNP
Contact information
Practice address
333 N SANTA ROSA, SAN ANTONIO, TX 78207-3108
(210) 704-3030
Mailing address
333 N SANTA ROSA, SAN ANTONIO, TX 78207-3108
(210) 704-3030
(830) 310-8156
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP117107
TX
363LP0200X
Pediatric Nurse Practitioner
AP117107
TX
363LP2300X
Primary Care Nurse Practitioner
AP117107
TX
Other
Enumeration date
01/27/2009
Last updated
10/22/2025
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