Individual provider · NPI-1
Mario Cervantes-Vazquez, M.D.
Pathology, Anatomic Pathology & Clinical Pathology · Kingwood, TX
NPI number1245234616
StatusActive
Last updated in NPPESOct 25, 2022
Details
- NPI
- 1245234616
- Entity type
- Individual (NPI-1)
- Name
- Mario Cervantes-Vazquez
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 13, 2005
- Certification date
- Oct 25, 2022
- Last updated
- Oct 25, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207ZP0102X | Pathology, Anatomic Pathology & Clinical Pathology | H7953 | TX | Yes |
| 207ZH0000X | Pathology, Hematology | H7953 | TX |
Practice location
22999 Highway 59 NKingwood, TX 77339-4412
Phone 281-348-8279 · Fax 281-348-8275
Mailing address
Po Box 746559Atlanta, GA 30374-6559
Phone 281-348-8279 · Fax 281-348-8275
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