MEDICARE: CARLOS E. CHINEA M.D., P.A.

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	207RG0100X	Gastroenterology Physician	K8072	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1639192370	OTHER	TX	INDIVIDUAL NPI
2	8H8100	OTHER	TX	BCBS
3	7906007	OTHER	TX	AETNA

General Provider Information

NPI Number	:	1639185499
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CARLOS E. CHINEA M.D., P.A.

Provider Business Mailing Address
First Line	:	605 E SAN ANTONIO ST
Second Line	:	SUITE 414E
City	:	VICTORIA
State	:	TX
Zip	:	77901-6040
Country	:	US
Telephone Number	:	361-576-3277
Fax Number	:	361-576-3271

Provider Business Practice Location Address
First Line	:	2700 CITIZENS PLZ STE 400
Second Line	:
City	:	VICTORIA
State	:	TX
Zip	:	77901-5757
Country	:	US
Telephone Number	:	361-576-3277
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CARLOS E. CHINEA
Credential	:	M.D.
Telephone Number	:	361-576-3277

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	11/05/2024

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