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NPI Code Detail

MEDICARE: SUSANA KORINA CARVAJAL

MEDICARE: SUSANA KORINA CARVAJAL
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
1390200000XStudent in an Organized Health Care Education/Training ProgramTX

General Provider Information

NPI Number : 1417899410
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSANA KORINA CARVAJAL
Provider Business Mailing Address
First Line : 17914 VINTAGE WOOD LN
Second Line :
City : SPRING
State : TX
Zip : 77379-3979
Country : US
Telephone Number : 346-208-4422
Fax Number : 346-208-4422
Provider Business Practice Location Address
First Line : 3533 S ALAMEDA ST
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78411-1721
Country : US
Telephone Number : 361-694-5000
Fax Number : 361-694-5000
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/08/2026
Last Update Date : 04/08/2026

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Directions to “ SUSANA KORINA CARVAJAL ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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