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General NPI Number Information
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NPI Number | 1720045156
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Entity Type | Organization
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Legal Business Name | CARLOS A REGALADO, M.D., P.A.
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Dates
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Enumeration Date | 04/28/2006
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Last Update Date | 09/01/2011
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Provider Practice Location Address
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Address Line | 2121 E GRIFFIN PKWY SUITE 1
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City | MISSION
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State | TX
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Zip | 78572-3241
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Country | US
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Telephone | 956-424-3116
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Fax | 956-424-3133
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Provider Business Mailing Address
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Address Line | 2121 E GRIFFIN PKWY SUITE 1
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City | MISSION
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State | TX
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Zip | 78572-3241
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Country | US
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Telephone | 956-424-3116
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Fax | 956-424-3133
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. CARLOS A REGALADO
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Credential | M.D.
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Telephone | 956-424-3116
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | J8103
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License Number State | TX
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