Provider Demographics
NPI:1154412237
Name:CEPEDA, NITZIA ESTHER (MD)
Entity type:Individual
Prefix:
First Name:NITZIA
Middle Name:ESTHER
Last Name:CEPEDA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NITZIA
Other - Middle Name:ESTHER
Other - Last Name:REYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11851 JOLLYVILLE RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78759-2338
Mailing Address - Country:US
Mailing Address - Phone:512-219-5550
Mailing Address - Fax:512-219-5551
Practice Address - Street 1:11851 JOLLYVILLE RD
Practice Address - Street 2:SUITE 204
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-2338
Practice Address - Country:US
Practice Address - Phone:512-219-5550
Practice Address - Fax:512-219-5551
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL6823208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics