Provider Demographics
NPI:1598705519
Name:CARDENAS, VICTOR J (MD)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:J
Last Name:CARDENAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3111 ANN ARBOR CT
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3709
Mailing Address - Country:US
Mailing Address - Phone:713-819-1077
Mailing Address - Fax:281-491-0379
Practice Address - Street 1:3111 ANN ARBOR CT
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-3709
Practice Address - Country:US
Practice Address - Phone:713-819-1077
Practice Address - Fax:281-491-0379
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2012-11-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXE04182084P0800X, 2084P0802X, 2084P0804X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0802XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Psychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE78706Medicare UPIN