Provider Demographics
NPI:1932326014
Name:SOUTHWEST PAIN & INJURY
Entity Type:Organization
Organization Name:SOUTHWEST PAIN & INJURY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EDDIE
Authorized Official - Middle Name:LEON
Authorized Official - Last Name:CERDAY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:210-826-2262
Mailing Address - Street 1:12770 CIMARRON PATH STE 116
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3415
Mailing Address - Country:US
Mailing Address - Phone:210-826-2262
Mailing Address - Fax:210-509-4813
Practice Address - Street 1:12770 CIMARRON PATH STE 116
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3415
Practice Address - Country:US
Practice Address - Phone:210-826-2262
Practice Address - Fax:210-509-4813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXMDF9289TX174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX=========OtherFACILILY