Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | N5066 | TX |
NPI | 1073727442 |
---|---|
Provider Name | Carla Garcia Carreno |
First Address | Carrollton, TX 75007-1645 |
Second Address | Carrollton, TX 75007-1645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2007 |
Last Update Date | 07/06/2019 |