Individual
DR. CECILIA MARINA CERVANTES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
5114 BALCONES WOODS DR, SUITE 307-347, AUSTIN, TX 78759-5273
(512) 466-2621
(888) 550-6132
Mailing address
5114 BALCONES WOODS DR STE 307-347, AUSTIN, TX 78759-5273
(512) 667-4343
(512) 249-6119
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
J1631
TX
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
26062004
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0029EN
BLUE CROSS NUMBER
TX
05
—
124383405
—
TX
01
—
4299864
AETNA PROVIDER NUMBER
—
01
—
6127379
CIGNA PROVIDER NUMBER
TX
01
—
80-0881204
TAX ID
TX
01
—
8AJ946
BLUE CROSS PROVIDER #
TX
Enumeration date
09/14/2006
Last updated
08/31/2020
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