Provider Demographics
NPI:1023471398
Name:GARCIA CERVERA, CARLOS JAVIER (SA-C)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:JAVIER
Last Name:GARCIA CERVERA
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2907 EADS PL # 79935
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-1813
Mailing Address - Country:US
Mailing Address - Phone:915-227-7081
Mailing Address - Fax:
Practice Address - Street 1:2907 EADS PL # 79935
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-1813
Practice Address - Country:US
Practice Address - Phone:915-227-7081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-03
Last Update Date:2016-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16-184246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant