Provider Demographics
NPI:1285137901
Name:RENDON, IRIS (LVN)
Entity type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:RENDON
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 UPPER BALCONES RD
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78006-8546
Mailing Address - Country:US
Mailing Address - Phone:210-442-9374
Mailing Address - Fax:
Practice Address - Street 1:7 UPPER BALCONES RD
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78006-8546
Practice Address - Country:US
Practice Address - Phone:210-442-9374
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-09
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX314141164X00000X
TXRCP020058072278G1100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2278G1100XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, CertifiedGeneral Care
No164X00000XNursing Service ProvidersLicensed Vocational Nurse