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General NPI Number Information
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NPI Number | 1790033512
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Entity Type | Organization
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Legal Business Name | GERARDO E. CARCAMO, MD PA
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Dates
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Enumeration Date | 08/28/2012
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Last Update Date | 08/28/2012
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Provider Practice Location Address
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Address Line | 414 NAVARRO ST SUITE 810
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City | SAN ANTONIO
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State | TX
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Zip | 78205-2577
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Country | US
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Telephone | 210-220-1726
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Fax | 210-224-3058
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Provider Business Mailing Address
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Address Line | 414 NAVARRO ST SUITE 810
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City | SAN ANTONIO
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State | TX
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Zip | 78205-2577
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Country | US
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Telephone | 210-220-1726
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Fax | 210-224-3058
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Authorized Official
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Title or Position | M.D., PRESIDENT
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Name | DR. GERARDO E CARCAOM
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Credential | M.D.
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Telephone | 210-220-1726
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | K4014
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License Number State | TX
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