Provider Demographics
NPI:1851091516
Name:CINECERTICA PLLC
Entity Type:Organization
Organization Name:CINECERTICA PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDOVAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-287-0134
Mailing Address - Street 1:1547 E COMMON ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-3154
Mailing Address - Country:US
Mailing Address - Phone:512-287-0134
Mailing Address - Fax:
Practice Address - Street 1:1547 E COMMON ST
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-3154
Practice Address - Country:US
Practice Address - Phone:512-287-0134
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-09
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health