Provider Demographics
NPI:1437384807
Name:DE CARDONA, EUARDO ALFREDO
Entity type:Individual
Prefix:DR
First Name:EUARDO
Middle Name:ALFREDO
Last Name:DE CARDONA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11334 SSG SIMS ST FORT BLISS
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79908
Mailing Address - Country:US
Mailing Address - Phone:915-910-3653
Mailing Address - Fax:
Practice Address - Street 1:11334 SSG SIMS ST FORT BLISS
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79908
Practice Address - Country:US
Practice Address - Phone:915-742-0086
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2025-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR28311223P0300X
TX40291122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0300XDental ProvidersDentistPeriodontics