Organization
MARIO CERVANTES, M.D., PA
Active
Other names
CLINICA ANGELES
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIO CERVANTES M.D. (PRESIDENT)
(832) 638-6072
Entity
Organization
Contact information
Practice address
4922 LOCUST ST, BELLAIRE, TX 77401-4040
(832) 638-6072
(888) 327-1505
Mailing address
5210 MAPLE ST, BELLAIRE, TX 77401
(832) 638-6072
(888) 327-1505
Taxonomy
Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
H7953
TX
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
H7953
TX
208D00000X
General Practice Physician
Primary
H7953
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200034101
—
TX
01
—
45D2028678
CLIA
TX
Enumeration date
12/31/2008
Last updated
11/19/2013
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