Individual
JESUS RICARDO PENA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, BSN, CLT
Contact information
Practice address
1516 CYNTHIA ST, EDINBURG, TX 78539-5442
(956) 457-3247
Mailing address
1516 CYNTHIA ST, EDINBURG, TX 78539-5442
(956) 457-3247
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
713779
TX
Other
Enumeration date
01/15/2014
Last updated
01/15/2014
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