Provider Demographics
NPI:1194987164
Name:CEDRONE, ANTHONY JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:JOSEPH
Last Name:CEDRONE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7800 SHOAL CREEK BLVD
Mailing Address - Street 2:SUITE 205N
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78757-1098
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2352 MEADOWS BLVD STE 115
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80109-8407
Practice Address - Country:US
Practice Address - Phone:303-744-1065
Practice Address - Fax:303-733-1699
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2019-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXP6794207RC0000X, 207RI0011X
CODR.0061576207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX359456YNTUMedicare PIN
TX359456YKZXMedicare PIN