Individual
MARIO CERVANTES-VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22999 HIGHWAY 59 N, KINGWOOD, TX 77339-4412
(281) 348-8279
(281) 348-8275
Mailing address
PO BOX 746559, ATLANTA, GA 30374-6559
(281) 348-8279
(281) 348-8275
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
H7953
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
H7953
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130817316
—
TX
01
—
220033031
RAILROAD MEDICARE
TX
Enumeration date
06/13/2005
Last updated
10/25/2022
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