Provider Demographics
NPI:1881997138
Name:CADENA, ALMA DELIA (PA)
Entity type:Individual
Prefix:
First Name:ALMA
Middle Name:DELIA
Last Name:CADENA
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 841656
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-1656
Mailing Address - Country:US
Mailing Address - Phone:903-531-5000
Mailing Address - Fax:
Practice Address - Street 1:5414 S BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-1335
Practice Address - Country:US
Practice Address - Phone:903-581-1601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-08
Last Update Date:2014-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA05940363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX75-0818167-048OtherTRICARE
TX220471101Medicaid
TX75-0818167-015OtherTRICARE
TX75-2616977-001OtherTRICARE
TX752616977002OtherTRICARE
TX8811NFOtherBCBS
TX220471103Medicaid
TX75-0218167-044OtherTRICARE
TX8282NDOtherBCBS BLUE
TX835N38OtherBCBS
TXP01276466OtherRAIL ROAD
TXTIN PLUS 022OtherTRICARE
TX75-2616977-028OtherTRICARE
TX75-1976930-005OtherTRICARE
TX220471102Medicaid
TX220471104Medicaid
TXP0181261OtherRAIL ROAD
TXP00925642Medicare PIN
TXP01276466OtherRAIL ROAD
TX752616977002OtherTRICARE
TX75-2616977-001OtherTRICARE