| Doctor Name: | DR. GABRIEL CARDENAS |
| NPI Number: | 1043521719 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.P.M. |
| License Number: | 2010021578 |
| Business Practice Address: | 6812 State Route 162 Suite 21 Maryville, IL - 620628553 |
| Business Phone Number: | 6182882835 |
| Business Fax Number: | 6182886162 |
| Mailing Address: | 521 Meadow Glen Ct, HOUSE SPRINGS |
| State: | MO |
| Postal Code: | 630514320 |
| Phone Number: | 6185141308 |
| Fax Number: | |
| NPI Enumeration Date: | 06/28/2010 |
| NPI Last Update Date: | 05/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0103X |
| License Number: | 2010021578 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot & Ankle Surgery |
| Taxonomy Definition: | |