Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | H0232 | TX |
NPI | 1023030574 |
---|---|
Provider Name | Carlos Javier Cardenas |
First Address | Mcallen, TX 78502-6139 |
Second Address | Edinburg, TX 78539-1412 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/07/2006 |
Last Update Date | 20/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
098512903 | (05) | TX |
098512904 | (05) | TX |