Provider Demographics
NPI:1932595915
Name:CADENA, DAVID CARLOS JR (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CARLOS
Last Name:CADENA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:25723 OLD FREDERICKSBURG RD
Mailing Address - Street 2:
Mailing Address - City:BOERNE
Mailing Address - State:TX
Mailing Address - Zip Code:78015-6605
Mailing Address - Country:US
Mailing Address - Phone:210-450-6800
Mailing Address - Fax:210-450-6894
Practice Address - Street 1:25723 OLD FREDERICKSBURG RD
Practice Address - Street 2:
Practice Address - City:BOERNE
Practice Address - State:TX
Practice Address - Zip Code:78015-6605
Practice Address - Country:US
Practice Address - Phone:210-450-6800
Practice Address - Fax:210-450-6894
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXR6754207Q00000X
TXBP10052571390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX384912701Medicaid
TX384912702OtherCSHCN