Healthcare Provider Details

I. General information

NPI: 1023109188
Provider Name (Legal Business Name): CARLOS F VERA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2006
Last Update Date: 07/21/2021
Certification Date: 07/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6080 W 92ND AVE STE 1000
WESTMINSTER CO
80031-2935
US

IV. Provider business mailing address

750 W HAMPDEN AVE STE 105
ENGLEWOOD CO
80110-2167
US

V. Phone/Fax

Practice location:
  • Phone: 303-427-0796
  • Fax: 303-429-9399
Mailing address:
  • Phone: 303-341-4730
  • Fax: 303-341-4708

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number38482
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: