Provider Demographics
NPI:1295189124
Name:DR. JORGE A. CARRION, O.D. PLLC
Entity Type:Organization
Organization Name:DR. JORGE A. CARRION, O.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:A
Authorized Official - Last Name:CARRION
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:956-791-3277
Mailing Address - Street 1:5300 SAN DARIO AVE # 136B
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-3000
Mailing Address - Country:US
Mailing Address - Phone:956-791-3277
Mailing Address - Fax:956-712-0237
Practice Address - Street 1:5300 SAN DARIO AVE # 136B
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-3000
Practice Address - Country:US
Practice Address - Phone:956-791-3277
Practice Address - Fax:956-712-0237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4437152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty