Provider Demographics
NPI:1114562006
Name:NAVARRETE, REYNA LORENA
Entity Type:Individual
Prefix:
First Name:REYNA
Middle Name:LORENA
Last Name:NAVARRETE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5602 PRESIDIO PKWY APT 5320
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3283
Mailing Address - Country:US
Mailing Address - Phone:956-789-1190
Mailing Address - Fax:
Practice Address - Street 1:5602 PRESIDIO PKWY APT 5320
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3283
Practice Address - Country:US
Practice Address - Phone:956-789-1190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-14
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX351357164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse