MEDICARE: VICTOR J CARDENAS M.D.

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	2084P0800X	Psychiatry Physician	E0418	TX
2	2084P0802X	Addiction Psychiatry Physician	E0418	TX
3	2084P0804X	Child & Adolescent Psychiatry Physician	E0418	TX
4	2084P0805X	Geriatric Psychiatry Physician	E0418	TX

General Provider Information

NPI Number	:	1598705519
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTOR J CARDENAS M.D.

Provider Business Mailing Address
First Line	:	3111 ANN ARBOR CT
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3709
Country	:	US
Telephone Number	:	713-819-1077
Fax Number	:	281-491-0379

Provider Business Practice Location Address
First Line	:	3111 ANN ARBOR CT
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3709
Country	:	US
Telephone Number	:	713-819-1077
Fax Number	:	281-491-0379

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/07/2006
Last Update Date	:	11/19/2012

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