Basic Information
| Provider Information | |||||||||
| NPI: | 1659582930 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DRENGLER | ||||||||
| FirstName: | CORAL | ||||||||
| MiddleName: | ELIZABETH | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 410 HAPPY TRL | ||||||||
| Address2: | |||||||||
| City: | SHAVANO PARK | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782311424 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104161477 | ||||||||
| FaxNumber: | 2107331331 | ||||||||
| Practice Location | |||||||||
| Address1: | 4415 W PIEDRAS DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782281212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2107331212 | ||||||||
| FaxNumber: | 2107331331 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/25/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | K9772 | TX | Y | Other Service Providers | Specialist |
No ID Information.