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NPI Code Detail

MEDICARE: U.S.D. RENAISSANCE, LLC

MEDICARE: U.S.D. RENAISSANCE, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1251E00000XHome Health Agency

General Provider Information

NPI Number : 1386925311
Entity Type Code : Organization
Provider Name (Legal Business Name) : U.S.D. RENAISSANCE, LLC
Provider Business Mailing Address
First Line : 1020 CORPUS CHRISTI ST
Second Line :
City : LAREDO
State : TX
Zip : 78040-5208
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1020 CORPUS CHRISTI ST
Second Line :
City : LAREDO
State : TX
Zip : 78040-5208
Country : US
Telephone Number : 956-337-4381
Fax Number :
Authorized Official
Title or Position : OWNER/ADMINISTRATOR
Name : MRS. ELISA SUSANNA DRUKER
Credential : M.A. CCC- SLP
Telephone Number : 956-723-5700
Provider Enumeration Date : 09/04/2011
Last Update Date : 02/07/2012

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