IMELDA PENA

LIVE OAK, TX
NPI1508639964
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224P00000X Prosthetist
(Licence: TX  1312)
Additional Taxonomies222Z00000X Orthotist
(Licence: TX  1312)
Enumeration Date2023-11-06
Last Update Date2023-11-06
Business Address
IMELDA PENA CPO
12315 JUDSON RD STE 206
LIVE OAK, TX 78233-3264
Phone number: 210-657-8100
Mailing Address
IMELDA PENA CPO
12315 JUDSON RD STE 206
LIVE OAK, TX 78233-3264
Phone number: 210-657-8100
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