Provider Demographics
NPI:1114421526
Name:CARDENAS-COMFORT, CAITLIN ROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:CAITLIN
Middle Name:ROSE
Last Name:CARDENAS-COMFORT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13355 NOEL RD STE 1100
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6694
Mailing Address - Country:US
Mailing Address - Phone:210-241-5179
Mailing Address - Fax:
Practice Address - Street 1:13355 NOEL RD STE 1100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6694
Practice Address - Country:US
Practice Address - Phone:210-241-5179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX390200000X
TXT1030208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program