Healthcare Provider Details

I. General information

NPI: 1376174482
Provider Name (Legal Business Name): CARLOS DAVID PARGAS COLINA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2020
Last Update Date: 05/14/2024
Certification Date: 05/14/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 MADISON AVENUE SUITE 447
MEMPHIS TN
38163-5216
US

IV. Provider business mailing address

UNIVERSITY OF TENNESSEE 920 MADISON AVENUE SUITE 447
MEMPHIS TN
38163-0001
US

V. Phone/Fax

Practice location:
  • Phone: 901-759-3274
  • Fax: 901-759-3278
Mailing address:
  • Phone: 901-759-3274
  • Fax: 901-759-3278

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207XP3100X
TaxonomyPediatric Orthopaedic Surgery Physician
License NumberV0094
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: