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NPI Code Detail

MEDICARE: CARDENAS HOLISTIC HEALTHCARE, PLLC

MEDICARE: CARDENAS HOLISTIC HEALTHCARE, PLLC
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
1363L00000XNurse PractitionerAP130985TX

General Provider Information

NPI Number : 1912453341
Entity Type Code : Organization
Provider Name (Legal Business Name) : CARDENAS HOLISTIC HEALTHCARE, PLLC
Provider Business Mailing Address
First Line : 4506 FRANKLIN DR
Second Line :
City : VERNON
State : TX
Zip : 76384-4915
Country : US
Telephone Number : 940-473-9043
Fax Number : 940-552-2473
Provider Business Practice Location Address
First Line : 1015 HILLCREST DR
Second Line :
City : VERNON
State : TX
Zip : 76384-3100
Country : US
Telephone Number : 940-552-5495
Fax Number : 940-552-2473
Authorized Official
Title or Position : SOLE MEMBER
Name : MRS. LOURDES E CARDENAS
Credential : AGNP
Telephone Number : 940-473-9043
Provider Enumeration Date : 08/26/2016
Last Update Date : 08/26/2016

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