Provider Demographics
NPI:1306181920
Name:ARREDONDO, CECIL RENE (MD)
Entity Type:Individual
Prefix:
First Name:CECIL
Middle Name:RENE
Last Name:ARREDONDO
Suffix:
Gender:M
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:PO BOX 340969
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78734-0017
Mailing Address - Country:US
Mailing Address - Phone:915-449-4406
Mailing Address - Fax:
Practice Address - Street 1:1626 MEDICAL CENTER DR
Practice Address - Street 2:SUITE 500
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-5010
Practice Address - Country:US
Practice Address - Phone:915-449-4406
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-07
Last Update Date:2012-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD5899174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist