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ERNESTO A CADORNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1301 PENNSYLVANIA AVE, FORT WORTH, TX 76104-2122
(817) 250-4906
Mailing address
1300 W TERRELL AVE STE K230, FORT WORTH, TX 76104-2820
(817) 250-4906

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
L6813
TX
208M00000X
Hospitalist Physician
04-25776
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
068002041
MEDICARE PTAN
KS
05
100175460D
KS
05
160998401
TX
01
8H3653
BLUE CROSS & BLUE SHIELD
TX
01
P00045886
RAIL ROAD MEDICARE
TX
Enumeration date
10/19/2006
Last updated
04/11/2022
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