Imelda Pena, CPO

NPI #1508639964 in Live Oak, Texas

Provider Information

NPI Number: 1508639964
Entity Type: Individual
Name: Imelda Pena, CPO
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Prosthetist
Credential: CPO
Enumeration Date: Nov 6, 2023
Last Updated: Nov 6, 2023

Practice Location

Address: 12315 JUDSON RD STE 206
City: Live Oak
State: Texas
ZIP Code: 78233-3264
Phone: (210) 657-8100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Orthotist	222Z00000X
Prosthetist	224P00000X	Primary

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Organizations

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