Provider Demographics
NPI:1164742821
Name:PUIG, CARLOS EDUARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:EDUARDO
Last Name:PUIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 N 23RD ST STE 1
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78501-6179
Mailing Address - Country:US
Mailing Address - Phone:956-540-5226
Mailing Address - Fax:952-246-4735
Practice Address - Street 1:3001 N 23RD ST STE 1
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78501-6179
Practice Address - Country:US
Practice Address - Phone:956-540-5226
Practice Address - Fax:952-246-4735
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-04
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN6588207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFP2088171OtherDEA
TXFP2088171OtherDEA