Provider Demographics
NPI:1346085826
Name:VIADER, RENAE
Entity type:Individual
Prefix:
First Name:RENAE
Middle Name:
Last Name:VIADER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5642 SAM SNEAD DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78552-9014
Mailing Address - Country:US
Mailing Address - Phone:956-200-3438
Mailing Address - Fax:
Practice Address - Street 1:905 MORGAN BLVD STE C
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-5134
Practice Address - Country:US
Practice Address - Phone:956-200-3438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374700000XNursing Service Related ProvidersTechnician