Provider Demographics
NPI:1467493874
Name:RENGER, HARVEY (MD)
Entity Type:Individual
Prefix:DR
First Name:HARVEY
Middle Name:
Last Name:RENGER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 N ESPLANADE ST
Mailing Address - Street 2:STE 101
Mailing Address - City:CUERO
Mailing Address - State:TX
Mailing Address - Zip Code:77954-4723
Mailing Address - Country:US
Mailing Address - Phone:361-275-2381
Mailing Address - Fax:361-275-2431
Practice Address - Street 1:2500 N ESPLANADE ST
Practice Address - Street 2:STE 101
Practice Address - City:CUERO
Practice Address - State:TX
Practice Address - Zip Code:77954-4723
Practice Address - Country:US
Practice Address - Phone:361-275-2381
Practice Address - Fax:361-275-2431
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD9623207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8P9302OtherBLUE CROSS BLUE SHIELD OF
TX8P9302OtherBLUE CROSS BLUE SHIELD OF
B25880Medicare UPIN