Doctor Name: | VICTOR CEPEDA |
NPI Number: | 1033524715 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | BP10049307 |
Business Practice Address: | 4900 Medical Dr Apt 0517 Broadstone On Medical San Antonio, TX - 782295389 |
Business Phone Number: | 2107639852 |
Business Fax Number: | |
Mailing Address: | 4900 Medical Dr, Apt 517 SAN ANTONIO |
State: | TX |
Postal Code: | 782294326 |
Phone Number: | 2108495032 |
Fax Number: | |
NPI Enumeration Date: | 06/21/2014 |
NPI Last Update Date: | 03/15/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | BP10049307 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |