Healthcare Provider Details

I. General information

NPI: 1902980014
Provider Name (Legal Business Name): CARLOS L. ARTEAGA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 05/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2201 INWOOD ROAD
DALLAS TX
75390-6307
US

IV. Provider business mailing address

PO BOX 845347
DALLAS TX
75284-7208
US

V. Phone/Fax

Practice location:
  • Phone: 214-645-8300
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberR7651
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: