Healthcare Provider Details

I. General information

NPI: 1053896365
Provider Name (Legal Business Name): CARLOS E PUIG MDPA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2018
Last Update Date: 08/12/2024
Certification Date: 08/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 N 23RD ST STE 1
MCALLEN TX
78501-6179
US

IV. Provider business mailing address

3001 N 23RD ST STE 1
MCALLEN TX
78501-6179
US

V. Phone/Fax

Practice location:
  • Phone: 956-540-5226
  • Fax:
Mailing address:
  • Phone: 956-540-5226
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VX0000X
TaxonomyObstetrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: CARLOS E PUIG
Title or Position: OWNER
Credential: MD
Phone: 956-540-5226