Provider Demographics
NPI:1215192364
Name:CARLOS G CIGARROA, M.D., P.A.
Entity Type:Organization
Organization Name:CARLOS G CIGARROA, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:G
Authorized Official - Last Name:CIGARROA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-728-8255
Mailing Address - Street 1:PO BOX 451428
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78045-0035
Mailing Address - Country:US
Mailing Address - Phone:956-728-8255
Mailing Address - Fax:956-728-0040
Practice Address - Street 1:702 E CALTON RD
Practice Address - Street 2:SUITE 101
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-3988
Practice Address - Country:US
Practice Address - Phone:956-728-8255
Practice Address - Fax:956-728-0400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2008-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1212207R00000X, 246W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246W00000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, CardiologyGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0039HXOtherBLUE CROSS BLUE SHIELD
TX133675208Medicaid
TX0039HXOtherBLUE CROSS BLUE SHIELD
TX00659TMedicare PIN