Individual
DR. RENA M POPMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
616 W RUSSELL PL, SAN ANTONIO, TX 78212-3658
(800) 257-8715
(800) 819-1655
Mailing address
1290 SKYLINE RD, DALE, TX 78616-3645
(512) 917-5685
(800) 819-1655
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
31139
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040880905
—
TX
05
—
164769501
—
TX
05
—
164769502
—
TX
01
—
86914A
BLUE CROSS BLUE SHEILD
TX
Enumeration date
07/12/2006
Last updated
07/09/2007
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