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General NPI Number Information
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NPI Number | 1134410624
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Entity Type | Individual
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Provider Name | SUZANNE WESLEY RIENSTRA MD
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Gender | Female
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Dates
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Enumeration Date | 05/02/2011
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 14615 SAN PEDRO AVE STE 218-220
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City | SAN ANTONIO
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State | TX
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Zip | 78232-4321
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Country | US
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Telephone | 210-644-3650
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Fax | 210-702-6979
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Provider Business Mailing Address
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Address Line | 903 W MARTIN ST # MS 49-2
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City | SAN ANTONIO
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State | TX
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Zip | 78207-0903
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Country | US
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Telephone | 201-358-5909
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Fax | 210-358-5940
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | Q0304
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | BP20047377
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License Number State | TX
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