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General NPI Number Information
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NPI Number | 1841455763
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Entity Type | Individual
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Provider Name | MARIO ALBERTO CERDAN TREVINO MD
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Gender | Male
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Dates
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Enumeration Date | 07/21/2008
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Last Update Date | 02/29/2024
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Provider Practice Location Address
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Address Line | 4770 N EXPRESSWAY 77/83 STE 204
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City | BROWNSVILLE
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State | TX
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Zip | 78526-3107
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Country | US
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Telephone | 956-452-1882
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Fax | 956-435-9133
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Provider Business Mailing Address
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Address Line | 6201 GREENLEIGH AVE
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City | MIDDLE RIVER
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State | MD
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Zip | 21220-2004
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Country | US
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Telephone | 410-933-2704
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | BP10032774
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | Q4914
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | D99486
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License Number State | MD
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