Individual
GEORGIA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
301 40TH ST, LUBBOCK, TX 79404-2746
(806) 743-9355
Mailing address
9105 BOSTON AVE, LUBBOCK, TX 79423-4205
(806) 743-4527
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
10645
TX
Other
Enumeration date
09/09/2025
Last updated
09/10/2025
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