1326027392 NPI number — DR. CARLOS M QUINONES M.D.

Table of content: DR. CARLOS M QUINONES M.D. (NPI 1326027392)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326027392 NPI number — DR. CARLOS M QUINONES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
QUINONES
Provider First Name:
CARLOS
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1326027392
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1915 BLUE QUAIL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FRIENDSWOOD
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77546-5899
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-648-5860
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 FERRY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GALVESTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77550-3185
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
409-766-5661
Provider Business Practice Location Address Fax Number:
409-766-4765
Provider Enumeration Date:
01/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  5424 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 5424 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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