=====================================================
General NPI Number Information
=====================================================
NPI Number | 1083112312
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | BRANDON CARDENAS
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2018
-----------------------------------------------------
Last Update Date | 08/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2001 S D ST
-----------------------------------------------------
City | MCALLEN
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78503-1854
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-686-2242
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1709 S TOLEDO ST
-----------------------------------------------------
City | PHARR
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 78577-9845
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 956-310-8557
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 1396674
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 225200000X
-----------------------------------------------------
Taxonomy Name | Physical Therapy Assistant
-----------------------------------------------------
License Number | 2134786
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------