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General NPI Number Information
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NPI Number | 1295189124
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Entity Type | Organization
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Legal Business Name | DR. JORGE A. CARRION, O.D. PLLC
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Dates
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Enumeration Date | 04/18/2016
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Last Update Date | 04/18/2016
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Provider Practice Location Address
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Address Line | 5300 SAN DARIO AVE # 136B
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City | LAREDO
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State | TX
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Zip | 78041-3000
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Country | US
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Telephone | 956-791-3277
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Fax | 956-712-0237
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Provider Business Mailing Address
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Address Line | 5300 SAN DARIO AVE # 136B
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City | LAREDO
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State | TX
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Zip | 78041-3000
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Country | US
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Telephone | 956-791-3277
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Fax | 956-712-0237
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. JORGE A CARRION
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Credential | O.D.
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Telephone | 956-791-3277
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 4437
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License Number State | TX
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