Provider Demographics
NPI:1689157950
Name:CEPEDES, ARMANDO
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:
Last Name:CEPEDES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11124 WURZBACH RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-2440
Mailing Address - Country:US
Mailing Address - Phone:210-615-5242
Mailing Address - Fax:
Practice Address - Street 1:11124 WURZBACH RD STE 100
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-2440
Practice Address - Country:US
Practice Address - Phone:210-615-5242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-12
Last Update Date:2018-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX63291164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse