Provider Demographics
NPI:1598407140
Name:CARDENAS, ROGELIO (FIRST ASSIST)
Entity Type:Individual
Prefix:MR
First Name:ROGELIO
Middle Name:
Last Name:CARDENAS
Suffix:
Gender:M
Credentials:FIRST ASSIST
Other - Prefix:MR
Other - First Name:ROY
Other - Middle Name:
Other - Last Name:CARDENAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FIRST ASSIST
Mailing Address - Street 1:8610 GLASS GEM DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-4656
Mailing Address - Country:US
Mailing Address - Phone:210-364-2515
Mailing Address - Fax:
Practice Address - Street 1:1139 E SONTERRA BLVD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-4347
Practice Address - Country:US
Practice Address - Phone:210-638-2000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-12
Last Update Date:2022-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical