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NPI Code Detail

MEDICARE: DENISE RANGEL-HOLBROOK IBCLC

MEDICARE:   DENISE  RANGEL-HOLBROOK  IBCLC
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
1174N00000XLactation Consultant (Non-RN)L-127966TX

General Provider Information

NPI Number : 1922654748
Entity Type Code : Individual
Provider Name (Legal Business Name) : DENISE RANGEL-HOLBROOK IBCLC
Provider Business Mailing Address
First Line : 13511 NORLAND ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-4916
Country : US
Telephone Number : 210-273-2092
Fax Number :
Provider Business Practice Location Address
First Line : 13511 NORLAND ST
Second Line :
City : SAN ANTONIO
State : TX
Zip : 78232-4916
Country : US
Telephone Number : 210-273-2092
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2019
Last Update Date : 08/16/2019

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Directions to “ DENISE RANGEL-HOLBROOK IBCLC” Practice Location

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