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General NPI Number Information
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NPI Number | 1437384807
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Entity Type | Individual
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Provider Name | DR. EUARDO ALFREDO DE CARDONA
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Gender | Male
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Dates
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Enumeration Date | 05/28/2009
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 11334 SSG SIMS ST FORT BLISS
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City | EL PASO
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State | TX
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Zip | 79908
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Country | US
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Telephone | 915-742-0086
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Fax |
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Provider Business Mailing Address
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Address Line | 11334 SSG SIMS ST FORT BLISS
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City | EL PASO
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State | TX
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Zip | 79908
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Country | US
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Telephone | 915-910-3653
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 2831
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License Number State | PR
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 40291
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License Number State | TX
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