Provider Demographics
NPI:1770866907
Name:CARDENAS, ALMA VICTORIA (DO)
Entity Type:Individual
Prefix:
First Name:ALMA
Middle Name:VICTORIA
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6212 PAPAGO RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79905-2137
Mailing Address - Country:US
Mailing Address - Phone:915-235-3121
Mailing Address - Fax:
Practice Address - Street 1:HERMANOS ESCOBAR 3212
Practice Address - Street 2:
Practice Address - City:JUAREZ
Practice Address - State:CHIHUAHUA
Practice Address - Zip Code:32390
Practice Address - Country:MX
Practice Address - Phone:01152-611-2006
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-23
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ14920091223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics