Provider Demographics
NPI:1639434905
Name:CABRERA, ERNESTO (CSFA/ LSA)
Entity Type:Individual
Prefix:
First Name:ERNESTO
Middle Name:
Last Name:CABRERA
Suffix:
Gender:M
Credentials:CSFA/ LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 HEMS LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76001-5920
Mailing Address - Country:US
Mailing Address - Phone:817-308-0599
Mailing Address - Fax:
Practice Address - Street 1:829 HEMS LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76001-5920
Practice Address - Country:US
Practice Address - Phone:817-557-1628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2017-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant