Provider Demographics
NPI:1124243191
Name:AYERAS, EDGAR CEDENO (LPT)
Entity type:Individual
Prefix:MR
First Name:EDGAR
Middle Name:CEDENO
Last Name:AYERAS
Suffix:
Gender:M
Credentials:LPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1318 SUGAR CREEK BLVD
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77478-3928
Mailing Address - Country:US
Mailing Address - Phone:832-228-5331
Mailing Address - Fax:713-484-8133
Practice Address - Street 1:7407 BEECHNUT ST
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77074-4501
Practice Address - Country:US
Practice Address - Phone:713-484-8132
Practice Address - Fax:713-484-8133
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1-3412-2225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist