Provider Demographics
NPI:1588769871
Name:CISNEROS, ALFREDO AUGUSTO SR (MD)
Entity type:Individual
Prefix:DR
First Name:ALFREDO
Middle Name:AUGUSTO
Last Name:CISNEROS
Suffix:SR
Gender:M
Credentials:MD
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Mailing Address - Street 1:310 N ORCHARD DR
Mailing Address - Street 2:N/A
Mailing Address - City:ROSEBUD
Mailing Address - State:TX
Mailing Address - Zip Code:76570-0517
Mailing Address - Country:US
Mailing Address - Phone:254-583-2511
Mailing Address - Fax:254-583-2511
Practice Address - Street 1:1901 S 1ST ST (MEMORIAL DR.)
Practice Address - Street 2:N/A
Practice Address - City:TEMPLE
Practice Address - State:TX
Practice Address - Zip Code:76504
Practice Address - Country:US
Practice Address - Phone:254-778-4811
Practice Address - Fax:254-743-0514
Is Sole Proprietor?:No
Enumeration Date:2006-09-13
Last Update Date:2008-09-19
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Provider Licenses
StateLicense IDTaxonomies
TXE4817207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE4817OtherMY TX MEDICAL LICENSE