Provider Demographics
NPI:1124463740
Name:EDUARDO CEPEDA, MD, PLLC
Entity type:Organization
Organization Name:EDUARDO CEPEDA, MD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EDUARDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CEPEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-569-7090
Mailing Address - Street 1:4207 GARDENDALE ST
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3182
Mailing Address - Country:US
Mailing Address - Phone:210-616-9990
Mailing Address - Fax:210-298-9416
Practice Address - Street 1:700 S ZARZAMORA ST
Practice Address - Street 2:SUITE 206
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78207-5255
Practice Address - Country:US
Practice Address - Phone:210-569-7090
Practice Address - Fax:210-569-7089
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-09
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty