Organization
CEDAR PARK PEDIATRIC AND FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT CARDWELL (OFFICE MANAGER)
(512) 336-2777
Entity
Organization
Contact information
Practice address
345 CYPRESS CREEK RD, SUITE 104, CEDAR PARK, TX 78613-4483
(512) 336-2777
Mailing address
345 CYPRESS CREEK RD, SUITE 104, CEDAR PARK, TX 78613-4483
(512) 336-2777
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
208000000X
Pediatrics Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0068MS
BCBS
TX
Enumeration date
03/08/2007
Last updated
04/22/2015
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