Provider Demographics
NPI:1750464699
Name:CESANI-VAZQUEZ, FERNANDO (MD)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:
Last Name:CESANI-VAZQUEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7026 OLD KATY RD
Mailing Address - Street 2:SUITE 276
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-2133
Mailing Address - Country:US
Mailing Address - Phone:713-621-7436
Mailing Address - Fax:
Practice Address - Street 1:7026 OLD KATY RD
Practice Address - Street 2:SUITE 276
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-2133
Practice Address - Country:US
Practice Address - Phone:713-621-7436
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ68992085N0904X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085N0904XAllopathic & Osteopathic PhysiciansRadiologyNuclear Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF94311Medicare UPIN