Active NPI
Renee Anne Bellanger, PHARM.D.
- Nutrition Support Pharmacist
- San Antonio, TX
National Provider Identifier
1316039894
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nutrition Support Pharmacist
- License
- 24710
- Practice address
- 4301 Broadway
Cpo 99
San Antonio, TX 78209 - Phone
- (210) 883-1088
- Fax
- (210) 883-1013
- NPI assigned
- Sep 29, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutrition Support Pharmacist | 1835N1003X | 24710 | TX | Primary |
Addresses
Primary practice location
4301 Broadway
Cpo 99
San Antonio, TX 78209
Mailing address
10448 Remuda View Dr
San Antonio, TX 78254
Phone (210) 688-6254
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 24710 | Other | TX | PHARMACIST LICENSE |
| 11852 | Other | LA | PHARMACIST LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 24710 | TX | MD | Nutrition Support Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1186358400000",
"number": "1316039894",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10448 REMUDA VIEW DR",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78254",
"telephone_number": "210-688-6254",
"fax_number": "210-805-3013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4301 BROADWAY",
"address_2": "CPO 99",
"city": "SAN ANTONIO",
"state": "TX",
"postal_code": "78209",
"telephone_number": "210-883-1088",
"fax_number": "210-883-1013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BELLANGER",
"first_name": "RENEE",
"middle_name": "ANNE",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-29",
"last_updated": "2007-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "1835N1003X",
"taxonomy_group": "",
"desc": "Pharmacist, Nutrition Support",
"state": "TX",
"license": "24710",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "24710",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHARMACIST LICENSE",
"identifier": "11852",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Antonio, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.