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Individual

EMANUEL PENA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
COTA

Contact information

Practice address
2530 CENTRAL PALM DR, RIO GRANDE CITY, TX 78582-6648
(956) 487-3996
Mailing address
745 N EBONY AVE, ROMA, TX 78584-8153
(956) 437-0184

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
211293
TX

Other

Enumeration date
08/14/2018
Last updated
08/14/2018
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