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NPI Code Detail

MEDICARE: ELMER WILFREDO CARRILLO BARO MD

MEDICARE: ELMER WILFREDO CARRILLO BARO 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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1437977980
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELMER WILFREDO CARRILLO BARO MD
Provider Business Mailing Address
First Line : 3200 BROMLEY PL APT J102
Second Line :
City : MIDLAND
State : TX
Zip : 79705-1639
Country : US
Telephone Number : 713-240-2668
Fax Number :
Provider Business Practice Location Address
First Line : 701 W 5TH ST STE 3174
Second Line :
City : ODESSA
State : TX
Zip : 79763-4206
Country : US
Telephone Number : 432-703-5200
Fax Number : 432-335-5240
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2024
Last Update Date : 06/07/2026

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