MEDICARE: DR. CARLOS DAVID PARGAS COLINA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	207XP3100X	Pediatric Orthopaedic Surgery Physician	V0094	TX

General Provider Information

NPI Number	:	1376174482
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARLOS DAVID PARGAS COLINA MD

Provider Business Mailing Address
First Line	:	UNIVERSITY OF TENNESSEE 920 MADISON AVENUE SUITE 447
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38163-0001
Country	:	US
Telephone Number	:	901-759-3274
Fax Number	:	901-759-3278

Provider Business Practice Location Address
First Line	:	920 MADISON AVENUE SUITE 447
Second Line	:
City	:	MEMPHIS
State	:	TN
Zip	:	38163-5216
Country	:	US
Telephone Number	:	901-759-3274
Fax Number	:	901-759-3278

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/28/2020
Last Update Date	:	05/14/2024

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