Provider Demographics
NPI:1548402993
Name:CERDA, MIGDALIA
Entity Type:Individual
Prefix:
First Name:MIGDALIA
Middle Name:
Last Name:CERDA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2217 S STEWART RD
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-4203
Mailing Address - Country:US
Mailing Address - Phone:956-781-2624
Mailing Address - Fax:956-781-2624
Practice Address - Street 1:2217 S STEWART RD
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-4203
Practice Address - Country:US
Practice Address - Phone:956-781-2624
Practice Address - Fax:956-781-2624
Is Sole Proprietor?:No
Enumeration Date:2009-04-01
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide