Provider Demographics
NPI:1477067957
Name:RICK CARDENAS MD & ASSOCIATES LLC
Entity type:Organization
Organization Name:RICK CARDENAS MD & ASSOCIATES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RICK
Authorized Official - Middle Name:
Authorized Official - Last Name:CARDENAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:575-317-4113
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:CEDAR CREST
Mailing Address - State:NM
Mailing Address - Zip Code:87008-0043
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8005 MARBLE AVE NE STE 1
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-7901
Practice Address - Country:US
Practice Address - Phone:505-200-0667
Practice Address - Fax:505-255-1813
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-20
Last Update Date:2017-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty