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General NPI Number Information
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NPI Number | 1437115698
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Entity Type | Individual
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Provider Name | CARLOS ENRIQUE QUEZADA M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/25/2006
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 590 MEDICAL CIRCLE DRIVE WOMEN'S HEALTH CLINIC CRDAMC
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City | FT CAVAZOS
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State | TX
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Zip | 76554
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Country | US
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Telephone | 254-553-3772
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Fax | 254-288-8610
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Provider Business Mailing Address
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Address Line | 590 MEDICAL CENTER ROAD WOMEN'S HEALTH CLINIC
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City | FT CAVAZOS
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State | TX
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Zip | 76544
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Country | US
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Telephone | 254-553-1552
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Fax | 254-288-8109
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | P0471
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License Number State | TX
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