Provider Demographics
NPI:1528887999
Name:AGUIRRE OROZCO, ANA LORENA
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:LORENA
Last Name:AGUIRRE OROZCO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15503 VANCE JACKSON RD APT 1412
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3212
Mailing Address - Country:US
Mailing Address - Phone:210-763-4477
Mailing Address - Fax:
Practice Address - Street 1:15503 VANCE JACKSON RD APT 1412
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3212
Practice Address - Country:US
Practice Address - Phone:210-763-4477
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT85761133V00000X
DCDI200001705133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered