Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | J8573 | TX |
NPI | 1467435982 |
---|---|
Provider Name | Carlos Alberto Herrera |
First Address | Mcallen, TX 78502-2975 |
Second Address | Edinburg, TX 78539 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/11/2005 |
Last Update Date | 14/08/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
131181310 | (05) | TX |
131181312 | (05) | TX |