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General NPI Number Information
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NPI Number | 1609673094
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Entity Type | Individual
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Provider Name | ROSA MARIA DE LA CERDA-BLANC PA-C
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Gender | Female
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 11/11/2025
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Provider Practice Location Address
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Address Line | 2001 N JEFFERSON AVE STE 204
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City | MT PLEASANT
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State | TX
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Zip | 75455-2392
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Country | US
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Telephone | 903-577-6606
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Fax | 903-577-6245
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Provider Business Mailing Address
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Address Line | PO BOX 2731
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City | EAGLE PASS
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State | TX
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Zip | 78853-2731
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Country | US
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Telephone |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA18750
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License Number State | TX
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