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NPI Code Detail

MEDICARE: MR. CARLOS MANUEL PLASENCIA M.D.

MEDICARE: MR. CARLOS MANUEL PLASENCIA M.D.
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
1207Q00000XFamily Medicine PhysicianJ2737TX

General Provider Information

NPI Number : 1619054400
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. CARLOS MANUEL PLASENCIA M.D.
Provider Business Mailing Address
First Line : 2223 WEST LOOP S
Second Line :
City : HOUSTON
State : TX
Zip : 77027-3588
Country : US
Telephone Number : 956-371-0900
Fax Number :
Provider Business Practice Location Address
First Line : 2223 WEST LOOP S
Second Line :
City : HOUSTON
State : TX
Zip : 77027-3588
Country : US
Telephone Number : 956-371-0900
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 01/12/2016

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