Provider Demographics
NPI:1841449782
Name:CARDENAS, EVELYN JEANETTE (SLP)
Entity type:Individual
Prefix:
First Name:EVELYN
Middle Name:JEANETTE
Last Name:CARDENAS
Suffix:
Gender:F
Credentials:SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 N VETERANS BLVD STE E
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN
Mailing Address - State:TX
Mailing Address - Zip Code:78589-3226
Mailing Address - Country:US
Mailing Address - Phone:956-961-4230
Mailing Address - Fax:956-961-4231
Practice Address - Street 1:700 N VETERANS BLVD STE E
Practice Address - Street 2:
Practice Address - City:SAN JUAN
Practice Address - State:TX
Practice Address - Zip Code:78589-3226
Practice Address - Country:US
Practice Address - Phone:956-961-4230
Practice Address - Fax:956-961-4231
Is Sole Proprietor?:No
Enumeration Date:2008-09-16
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX103251235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist