Provider Demographics
NPI:1023546033
Name:RONDON, REINA ALEJANDRA (SA-C)
Entity Type:Individual
Prefix:MRS
First Name:REINA
Middle Name:ALEJANDRA
Last Name:RONDON
Suffix:
Gender:F
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 S MASON RD APT 712
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-5933
Mailing Address - Country:US
Mailing Address - Phone:832-398-9815
Mailing Address - Fax:
Practice Address - Street 1:10655 STEEPLETOP DR
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-4222
Practice Address - Country:US
Practice Address - Phone:281-890-4285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-03
Last Update Date:2017-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI15-463246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant