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General NPI Number Information
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NPI Number | 1942739123
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Entity Type | Organization
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Legal Business Name | OPTIMCUREA LLC
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Dates
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Enumeration Date | 06/09/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2440 D CHARLESTON STREET
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City | HOUSTON
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State | TX
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Zip | 77021
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Country | US
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Telephone | 281-764-7080
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Fax | 281-764-8759
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Provider Business Mailing Address
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Address Line | 2440D CHARLESTON STREET
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City | HOUSTON
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State | TX
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Zip | 77021
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Country | US
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Telephone | 281-764-7080
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Fax | 281-764-8759
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Authorized Official
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Title or Position | DOCTOR
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Name | DR. ROGER FRANCISCO CARBAJAL MENDOZA
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Credential | MD
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Telephone | 832-862-5747
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | P0559
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License Number State | TX
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