Healthcare Provider Details

I. General information

NPI: 1932131794
Provider Name (Legal Business Name): ARTURO CARRILLO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2006
Last Update Date: 07/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 PORT LANE
AMARILLO TX
79106-2470
US

IV. Provider business mailing address

1911 PORT LANE
AMARILLO TX
79106-2470
US

V. Phone/Fax

Practice location:
  • Phone: 806-358-4839
  • Fax: 806-358-4899
Mailing address:
  • Phone: 806-358-4839
  • Fax: 806-358-4899

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberF0144
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: