Provider Demographics
NPI:1518490085
Name:CARDENAS, NICOLAS JORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:NICOLAS
Middle Name:JORGE
Last Name:CARDENAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:6431 FANNIN ST
Mailing Address - Street 2:SUITE MSB 2.116
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-7640
Mailing Address - Fax:713-500-7647
Practice Address - Street 1:6431 FANNIN ST
Practice Address - Street 2:SUITE MSB 2.116
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-7640
Practice Address - Fax:713-500-7647
Is Sole Proprietor?:No
Enumeration Date:2017-04-11
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXT78802085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology