Provider Demographics
NPI:1942517602
Name:CABRERA, JESUS ENRIQUE (DMD)
Entity Type:Individual
Prefix:DR
First Name:JESUS
Middle Name:ENRIQUE
Last Name:CABRERA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2360 COUNTY ROAD 94 STE 110
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5135
Mailing Address - Country:US
Mailing Address - Phone:713-436-7697
Mailing Address - Fax:
Practice Address - Street 1:2360 COUNTY ROAD 94 STE 110
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5135
Practice Address - Country:US
Practice Address - Phone:713-436-7697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN191351223G0001X
TX263851223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No1223G0001XDental ProvidersDentistGeneral Practice