Healthcare Provider Details

I. General information

NPI: 1730377888
Provider Name (Legal Business Name): CARLOS CIGARROA, MD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2007
Last Update Date: 10/15/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 E CALTON RD SUITE 101
LAREDO TX
78041-3639
US

IV. Provider business mailing address

PO BOX 451428
LAREDO TX
78045-0035
US

V. Phone/Fax

Practice location:
  • Phone: 956-728-8255
  • Fax: 956-728-0400
Mailing address:
  • Phone: 956-728-8255
  • Fax: 956-728-0400

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code246W00000X
TaxonomyCardiology Technician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: CARLOS G CIGARROA
Title or Position: OWNER
Credential: MD
Phone: 956-728-8255