Provider Demographics
NPI:1629233200
Name:ALCIDES B CAIRUS MD PA
Entity type:Organization
Organization Name:ALCIDES B CAIRUS MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:DARLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CAIRUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-396-4994
Mailing Address - Street 1:1999 MEDICAL PKWY STE C
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-7579
Mailing Address - Country:US
Mailing Address - Phone:512-396-4994
Mailing Address - Fax:512-396-8969
Practice Address - Street 1:1999 MEDICAL PKWY STE C
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-7579
Practice Address - Country:US
Practice Address - Phone:512-396-4994
Practice Address - Fax:512-396-8969
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ALCIDES B CAIRUS MD PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG2660208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00G26GOtherBLUE CROSS BLUE SHIELD
TX128063805Medicaid
TX00G26GMedicare UPIN