Provider Demographics
NPI:1376125260
Name:ESPINOZA, RENEE APRIL SANTOS
Entity Type:Individual
Prefix:
First Name:RENEE
Middle Name:APRIL SANTOS
Last Name:ESPINOZA
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 1:5000 GATTIS SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:HUTTO
Mailing Address - State:TX
Mailing Address - Zip Code:78634-2025
Mailing Address - Country:US
Mailing Address - Phone:512-251-3173
Mailing Address - Fax:
Practice Address - Street 1:5000 GATTIS SCHOOL RD
Practice Address - Street 2:
Practice Address - City:HUTTO
Practice Address - State:TX
Practice Address - Zip Code:78634-2025
Practice Address - Country:US
Practice Address - Phone:512-251-3173
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-21
Last Update Date:2021-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX158931183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician