Individual
GEMINIS PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DIETITIAN
Contact information
Practice address
801 W 1ST ST, SAN JUAN, TX 78589-2276
(956) 787-8915
(956) 787-2021
Mailing address
801 W 1ST ST, SAN JUAN, TX 78589-2276
(956) 787-8915
(956) 787-2021
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
DT82788
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DT82788
DT82788
TX
Enumeration date
07/19/2013
Last updated
07/19/2013
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