Provider Demographics
NPI:1780987180
Name:MINICA, BRENDA (CD (CBI))
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:
Last Name:MINICA
Suffix:
Gender:F
Credentials:CD (CBI)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:352 JOY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78223-6014
Mailing Address - Country:US
Mailing Address - Phone:210-706-0272
Mailing Address - Fax:
Practice Address - Street 1:352 JOY DR
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78223-6014
Practice Address - Country:US
Practice Address - Phone:210-706-0272
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula