MEDICARE: MS. BERTHA E. ARENAS FNP

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
1	363LF0000X	Family Nurse Practitioner	220053	TX

General Provider Information

NPI Number	:	1598768541
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. BERTHA E. ARENAS FNP

Provider Business Mailing Address
First Line	:	6902 GLEN FAIR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78239-2947
Country	:	US
Telephone Number	:	210-656-1436
Fax Number	:

Provider Business Practice Location Address
First Line	:	1702 N ALAMO ST
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78215-1201
Country	:	US
Telephone Number	:	210-224-1823
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	08/27/2008

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