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General NPI Number Information
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NPI Number | 1144281445
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Entity Type | Individual
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Provider Name | CARLOS DRAEGER GODINEZ JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 11/11/2014
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Provider Practice Location Address
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Address Line | 414 NAVARRO SUITE 816
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City | SAN ANTONIO
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State | TX
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Zip | 78205
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Country | US
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Telephone | 210-804-2020
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Fax | 210-519-3184
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Provider Business Mailing Address
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Address Line | 414 NAVARRO SUITE 1420
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City | SAN ANTONIO
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State | TX
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Zip | 78205
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Country | US
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Telephone | 210-804-2020
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Fax | 210-519-3184
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | D0066078
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | AFE63478
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | P6622
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License Number State | TX
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