Israel Pena, ATC, LAT, CES
Individual provider Active NPI Athletic Trainer · Fischer, TX
NPI 1043721160 · NPPES record last updated Oct 16, 2017
Key facts
- NPI
- 1043721160
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- Practice address
- 8555 FM 32
Fischer, TX 78623-2424 - Phone
- (830) 885-1751
- NPI assigned
- Oct 16, 2017
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Yes |
Addresses
Primary practice location
8555 FM 32
Fischer, TX 78623-2424
Mailing address
8555 FM 32
Fischer, TX 78623-2424
Phone (830) 885-1751
Other providers in Fischer, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 16, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.