Provider Demographics
NPI:1417286105
Name:CARDIFF, LES
Entity Type:Individual
Prefix:
First Name:LES
Middle Name:
Last Name:CARDIFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27495 RANCH ROAD 12
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4904
Mailing Address - Country:US
Mailing Address - Phone:512-858-1984
Mailing Address - Fax:512-858-5078
Practice Address - Street 1:27495 RANCH ROAD 12
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-4904
Practice Address - Country:US
Practice Address - Phone:512-858-1984
Practice Address - Fax:512-858-5078
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist