Provider Demographics
NPI:1770172058
Name:REALEGENO-ARELLANO, ANGIE ABLEEN (DC)
Entity type:Individual
Prefix:DR
First Name:ANGIE
Middle Name:ABLEEN
Last Name:REALEGENO-ARELLANO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 SAN JACINTO LN
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77803-2654
Mailing Address - Country:US
Mailing Address - Phone:979-595-4881
Mailing Address - Fax:
Practice Address - Street 1:707 TEXAS AVE S # 202D
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-1967
Practice Address - Country:US
Practice Address - Phone:979-431-8567
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-12
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15745111N00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor