MEDICARE: ROSARIO C. CARREON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician	H1750	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154307486
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROSARIO C. CARREON MD

Provider Business Mailing Address
First Line	:	1000 GARLAND JOHNSTON DR
Second Line	:	#C
City	:	VERNON
State	:	TX
Zip	:	76384-4097
Country	:	US
Telephone Number	:	940-553-4333
Fax Number	:	940-553-4566

Provider Business Practice Location Address
First Line	:	1000 GARLAND JOHNSTON DR
Second Line	:	#C
City	:	VERNON
State	:	TX
Zip	:	76384-4097
Country	:	US
Telephone Number	:	940-553-4333
Fax Number	:	940-553-4566

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/19/2005
Last Update Date	:	09/11/2008

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Directions to “ ROSARIO C. CARREON MD” Practice Location

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