Provider Demographics
NPI:1689657546
Name:CENIZA, ADOLFO NOEL (MD)
Entity Type:Individual
Prefix:DR
First Name:ADOLFO
Middle Name:NOEL
Last Name:CENIZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:11838 MEDPARK DR STE 103
Mailing Address - Street 2:
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-0278
Mailing Address - Country:US
Mailing Address - Phone:817-293-4304
Mailing Address - Fax:817-293-7244
Practice Address - Street 1:11801 SOUTH FWY
Practice Address - Street 2:
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7021
Practice Address - Country:US
Practice Address - Phone:817-293-4304
Practice Address - Fax:817-293-7244
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4301066033207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
220026384OtherRAILROAD MEDICARE
MI74790004Medicare ID - Type Unspecified