Provider Demographics
NPI:1427253186
Name:MARIA LUISA C PENA
Entity type:Organization
Organization Name:MARIA LUISA C PENA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:LUISA C
Authorized Official - Last Name:PENA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:956-728-0033
Mailing Address - Street 1:2515 N BARTLETT AVE
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78043-2138
Mailing Address - Country:US
Mailing Address - Phone:956-728-0033
Mailing Address - Fax:956-728-0133
Practice Address - Street 1:2515 N BARTLETT AVE
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78043-2138
Practice Address - Country:US
Practice Address - Phone:956-728-0033
Practice Address - Fax:956-728-0133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-20
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management