Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | J9990 | TX |
Y | 2080P0208X | Pediatric Infectious Diseases | J9990 | TX |
NPI | 1487695946 |
---|---|
Provider Name | Enrique Caceres |
First Address | Mcallen, TX 78504-0395 |
Second Address | Mcallen, TX 78504-2686 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 14/04/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
044292303 | (05) | TX |
044292306 | (05) | TX |
109700100 | VALLEY HEALTH PLAN (01) | TX |
G25010 | (02) | TX |