Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | D6978 | TX |
NPI | 1114092111 |
---|---|
Provider Name | Hugo Francisco Carvajal |
First Address | San Antonio, TX 78258-3944 |
Second Address | San Antonio, TX 78258-3944 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D48106 | (02) | TX |