Provider Demographics
NPI:1114108198
Name:URENA, JOHANNA G (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHANNA
Middle Name:G
Last Name:URENA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:16620 N US HIGHWAY 281 STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78232-2679
Mailing Address - Country:US
Mailing Address - Phone:210-614-1231
Mailing Address - Fax:210-809-4989
Practice Address - Street 1:1123 N MAIN AVE STE 120
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78212-4738
Practice Address - Country:US
Practice Address - Phone:210-226-2001
Practice Address - Fax:210-226-5211
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2023-09-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXN5447207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX218072101Medicaid
TX218072101Medicaid