Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | P0356 | TX |
N | 225XN1300X | Occupational Therapist - Neurorehabilitation | P0356 | TX |
NPI | 1114180700 |
---|---|
Provider Name | Dr. Edgar Heberto Carretero |
First Address | San Antonio, TX 78216 |
Second Address | San Antonio, TX 78216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/07/2008 |
Last Update Date | 15/10/2014 |