Healthcare Provider Details

I. General information

NPI: 1598858565
Provider Name (Legal Business Name): CARL FRANK PALUMBO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 CAMPBELL RD
HOUSTON TX
77024-2804
US

IV. Provider business mailing address

950 CAMPBELL RD
HOUSTON TX
77024-2804
US

V. Phone/Fax

Practice location:
  • Phone: 713-464-0077
  • Fax: 713-464-9582
Mailing address:
  • Phone: 713-464-0077
  • Fax: 713-464-9582

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberM4418
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: