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General NPI Number Information
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NPI Number | 1306895602
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Entity Type | Individual
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Provider Name | JUAN CARLOS VEGA SOLIVEN MD
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Gender | Male
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Dates
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Enumeration Date | 05/06/2006
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Last Update Date | 08/21/2019
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Provider Practice Location Address
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Address Line | 3330 MASONIC DR CHRISTUS CABRINI GROUP PRACTICE INTENSIVISTS
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City | ALEXANDRIA
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State | LA
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Zip | 71301-3841
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Country | US
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Telephone | 318-448-6700
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Fax | 318-483-4066
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Provider Business Mailing Address
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Address Line | 919 HIDDEN RDG
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City | IRVING
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State | TX
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Zip | 75038-3813
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Country | US
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Telephone | 469-282-2711
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Fax | 469-282-0996
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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 | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number | MD12724R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | MD.12724R
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License Number State | LA
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | MD12724R
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License Number State | LA
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