Provider Demographics
NPI:1649437559
Name:CADENA FAMILY PRACTICE
Entity type:Organization
Organization Name:CADENA FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ANTONIO
Authorized Official - Middle Name:
Authorized Official - Last Name:CADENA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:830-775-8700
Mailing Address - Street 1:2201 N BEDELL AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:DEL RIO
Mailing Address - State:TX
Mailing Address - Zip Code:78840-8020
Mailing Address - Country:US
Mailing Address - Phone:830-775-8700
Mailing Address - Fax:
Practice Address - Street 1:2201 N BEDELL AVE
Practice Address - Street 2:SUITE A
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-8020
Practice Address - Country:US
Practice Address - Phone:830-775-8700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-19
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ6360207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G27035Medicare UPIN
TXG05050Medicare UPIN