Basic Information
| Provider Information | |||||||||
| NPI: | 1417930595 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CISNEROZ | ||||||||
| FirstName: | ARNULFO | ||||||||
| MiddleName: | |||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 800 E HIGHWAY 71 | ||||||||
| Address2: | |||||||||
| City: | SMITHVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 789571730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122373214 | ||||||||
| FaxNumber: | 5122375768 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 E HIGHWAY 71 | ||||||||
| Address2: | |||||||||
| City: | SMITHVILLE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 789571730 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5122373214 | ||||||||
| FaxNumber: | 5122375768 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/22/2005 | ||||||||
| LastUpdateDate: | 02/26/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 02/26/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | J1929 | TX | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | J1929 | TX | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 140251325 | 05 | TX | MEDICAID |