Healthcare Provider Details

I. General information

NPI: 1447510011
Provider Name (Legal Business Name): JUAN ENRRIQUE ARENAS-HERRERA M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/17/2012
Last Update Date: 11/13/2024
Certification Date: 11/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E COURT ST
SEGUIN TX
78155-5129
US

IV. Provider business mailing address

PO BOX 1662
SEGUIN TX
78156-8662
US

V. Phone/Fax

Practice location:
  • Phone: 830-312-1116
  • Fax: 830-401-7640
Mailing address:
  • Phone: 702-453-3799
  • Fax: 702-453-5741

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberBP10044653
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: