Healthcare Provider Details

I. General information

NPI: 1508305434
Provider Name (Legal Business Name): KARILYN MEDINA NALES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/12/2017
Last Update Date: 05/28/2024
Certification Date: 05/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

520 E DONEGAN ST
SEGUIN TX
78155-6112
US

IV. Provider business mailing address

520 E DONEGAN ST
SEGUIN TX
78155-6112
US

V. Phone/Fax

Practice location:
  • Phone: 830-379-6300
  • Fax: 888-270-7559
Mailing address:
  • Phone: 805-529-7788
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number22206
License Number StatePR
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberT4002
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: