Provider Demographics
NPI:1851957989
Name:CARDENAS-FERNANDEZ, MARIANNA (MD)
Entity Type:Individual
Prefix:
First Name:MARIANNA
Middle Name:
Last Name:CARDENAS-FERNANDEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5219 CITY BANK PKWY STE 35
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79407-3545
Mailing Address - Country:US
Mailing Address - Phone:806-761-0334
Mailing Address - Fax:806-785-0872
Practice Address - Street 1:4420 114TH ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-7460
Practice Address - Country:US
Practice Address - Phone:806-761-0420
Practice Address - Fax:806-783-0301
Is Sole Proprietor?:No
Enumeration Date:2019-05-14
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXT9360207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine