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NPI Code Detail

MEDICARE: DR. MICHAEL JOHN CARRASCO M.D.

MEDICARE: DR. MICHAEL JOHN CARRASCO 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
1207P00000XEmergency Medicine PhysicianL1813TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2930115384OTHERTXMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
48A0479OTHERTXBCBS
58A9406OTHERTXBCBS
6930117001OTHERTXRAILROAD

General Provider Information

NPI Number : 1760467799
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL JOHN CARRASCO M.D.
Provider Business Mailing Address
First Line : PO BOX 201606
Second Line :
City : DALLAS
State : TX
Zip : 75320-1606
Country : US
Telephone Number : 972-758-3598
Fax Number :
Provider Business Practice Location Address
First Line : 3901 W 15TH ST
Second Line :
City : PLANO
State : TX
Zip : 75075-7738
Country : US
Telephone Number : 972-758-3598
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/13/2005
Last Update Date : 03/01/2011

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Directions to “ DR. MICHAEL JOHN CARRASCO M.D.” Practice Location

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