MEDICARE: CARLOS A CADENA DPM PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist	238	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	005399	OTHER	NM	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1679617229
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARLOS A CADENA DPM PC

Provider Business Mailing Address
First Line	:	2800 DORAL CT STE A
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-8616
Country	:	US
Telephone Number	:	575-521-0055
Fax Number	:	575-521-0077

Provider Business Practice Location Address
First Line	:	2800 DORAL CT STE A
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-8616
Country	:	US
Telephone Number	:	575-521-0055
Fax Number	:	575-521-0077

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CARLOS A CADENA
Credential	:	DPM
Telephone Number	:	575-521-0055

Provider Enumeration Date	:	02/16/2007
Last Update Date	:	02/26/2020

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