Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RX0202X | Medical Oncology | L7575 | TX |
NPI | 1174565089 |
---|---|
Provider Name | Dr. Carlos Alberto Taboada |
First Address | Dallas, TX 75391-1230 |
Second Address | Plano, TX 75075-7753 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2006 |
Last Update Date | 04/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
174440101 | (05) | TX |
174440103 | (05) | TX |
8S7055 | BLUE CROSS OF TEXAS (01) | TX |
I35315 | (02) | TX |