Provider Demographics
NPI:1447800834
Name:BRENES, ROCIO P
Entity Type:Individual
Prefix:
First Name:ROCIO
Middle Name:P
Last Name:BRENES
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 1:13023 COUNTRY GLADE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-2341
Mailing Address - Country:US
Mailing Address - Phone:830-469-6837
Mailing Address - Fax:
Practice Address - Street 1:403 SLUMBER PASS
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78260-5547
Practice Address - Country:US
Practice Address - Phone:830-469-6837
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider