Healthcare Provider Details

I. General information

NPI: 1093641516
Provider Name (Legal Business Name): ALANIS RENTERIA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12330 PELICANO DR SUITE B
EL PASO TX
79936
US

IV. Provider business mailing address

14800 SUSSER DR
EL PASO TX
79928-6801
US

V. Phone/Fax

Practice location:
  • Phone: 915-613-5255
  • Fax:
Mailing address:
  • Phone: 915-613-5255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: