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General NPI Number Information
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NPI Number | 1023248127
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Entity Type | Individual
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Provider Name | ASHLEIGH RENEAU RDH
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Gender | Female
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Dates
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Enumeration Date | 07/23/2009
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Last Update Date | 07/23/2009
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Provider Practice Location Address
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Address Line | 2640 E LEAGUE CITY PKWY STE 108
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City | LEAGUE CITY
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State | TX
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Zip | 77573-3369
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Country | US
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Telephone | 281-334-5109
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Fax |
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Provider Business Mailing Address
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Address Line | 3045 MARINA BAY DR APT 6103
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City | LEAGUE CITY
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State | TX
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Zip | 77573-2774
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Country | US
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Telephone | 361-548-6699
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 15277
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License Number State | TX
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