Healthcare Provider Details

I. General information

NPI: 1477401834
Provider Name (Legal Business Name): JOELYNN MONTSERRAT PENA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2026
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5711 MCPHERSON RD
LAREDO TX
78041-6837
US

IV. Provider business mailing address

1804 BRAZOS ST
ZAPATA TX
78076-3239
US

V. Phone/Fax

Practice location:
  • Phone: 956-614-1963
  • Fax:
Mailing address:
  • Phone: 956-231-4129
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: