Healthcare Provider Details

I. General information

NPI: 1205900339
Provider Name (Legal Business Name): MR. EUGENIO SAENZ III
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 03/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6118 PARKWAY
CORPUS CHRISTI TX
78414-2455
US

IV. Provider business mailing address

6118 PARKWAY
CORPUS CHRISTI TX
78414-2455
US

V. Phone/Fax

Practice location:
  • Phone: 361-883-2000
  • Fax: 361-883-0573
Mailing address:
  • Phone: 361-883-2000
  • Fax: 361-883-0573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZS0410X
TaxonomySurgical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: