MEDICARE: DEYANIRA OROSCO CHW INSTRUCTOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker	3907	TX

General Provider Information

NPI Number	:	1225991037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DEYANIRA OROSCO CHW INSTRUCTOR

Provider Business Mailing Address
First Line	:	9622 PLEASANTON PL
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78221-3340
Country	:	US
Telephone Number	:	210-328-3634
Fax Number	:

Provider Business Practice Location Address
First Line	:	3505 PLEASANTON RD
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78221-2734
Country	:	US
Telephone Number	:	210-328-3634
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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