Healthcare Provider Details
I. General information
NPI: 1548585037
Provider Name (Legal Business Name): CARIALEX TEXAS PA
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/29/2010
Last Update Date: 04/11/2012
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4302 S. SUGAR RD. SUITE 213
EDINBURG TX
78539
US
IV. Provider business mailing address
4302 S SUGAR RD SUITE 213
EDINBURG TX
78539-7073
US
V. Phone/Fax
- Phone: 787-306-7821
- Fax:
- Phone: 956-383-5700
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084N0600X |
| Taxonomy | Clinical Neurophysiology Physician |
| License Number | N3651 |
| License Number State | TX |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084N0400X |
| Taxonomy | Neurology Physician |
| License Number | N3651 |
| License Number State | TX |
VIII. Authorized Official
Name:
LUIS
ALEXANDER
FRIAS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 956-383-5700