Provider Demographics
NPI:1003288994
Name:CABAN, LUIS GERARDO (CSA)
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:GERARDO
Last Name:CABAN
Suffix:
Gender:M
Credentials:CSA
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Mailing Address - Street 1:PO BOX 692186
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77269-2186
Mailing Address - Country:US
Mailing Address - Phone:832-887-9037
Mailing Address - Fax:281-255-8693
Practice Address - Street 1:934 ARBOR PINE
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77375
Practice Address - Country:US
Practice Address - Phone:832-887-9037
Practice Address - Fax:281-255-8693
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-30
Last Update Date:2015-10-30
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical