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General NPI Number Information
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NPI Number | 1740364652
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Entity Type | Individual
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Provider Name | ROBERTO BEJARANO CARRASCO MD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 1911 PORT LANE ST B
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City | AMARILLO
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State | TX
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Zip | 79106
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Country | US
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Telephone | 806-359-9100
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Fax | 806-359-7022
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Provider Business Mailing Address
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Address Line | 1911 PORT LN STE B
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City | AMARILLO
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State | TX
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Zip | 79106-2471
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Country | US
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Telephone | 806-359-9100
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Fax | 806-359-7022
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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 | J1914
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License Number State | TX
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