Healthcare Provider Details

I. General information

NPI: 1952902223
Provider Name (Legal Business Name): CRISTINA RENTERIA HERRERA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2020
Last Update Date: 11/03/2020
Certification Date: 11/03/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1216 JUNCTION HWY
KERRVILLE TX
78028-4906
US

IV. Provider business mailing address

8132 COLONIAL WOODS
BOERNE TX
78015-4988
US

V. Phone/Fax

Practice location:
  • Phone: 830-896-5511
  • Fax: 830-896-7911
Mailing address:
  • Phone: 210-629-4937
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number56938
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: