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General NPI Number Information
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NPI Number | 1093073488
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Entity Type | Individual
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Provider Name | MARISOL ARIZMENDI BRETON-LEIJA RN
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Gender | Female
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Dates
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Enumeration Date | 04/24/2012
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Last Update Date | 05/01/2012
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Provider Practice Location Address
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Address Line | 903 W. MARTIN MS 49-2
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City | SAN ANTONIO
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State | TX
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Zip | 78207
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Country | US
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Telephone | 210-358-3441
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Fax | 210-358-5944
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Provider Business Mailing Address
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Address Line | PO BOX 87
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City | SAN ANTONIO
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State | TX
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Zip | 78291-0087
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Country | US
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Telephone | 210-358-9806
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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 | 163WC0400X
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Taxonomy Name | Case Management Registered Nurse
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License Number | 667305
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License Number State | TX
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