Provider Demographics
NPI:1346329661
Name:SAHAGUN-CARREON, IVONNE MARIA (MD)
Entity Type:Individual
Prefix:DR
First Name:IVONNE
Middle Name:MARIA
Last Name:SAHAGUN-CARREON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:IVONNE
Other - Middle Name:MARIE
Other - Last Name:SAHAGUN-CARREON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2115 STEPHENS PL STE 100
Mailing Address - Street 2:
Mailing Address - City:NEW BRAUNFELS
Mailing Address - State:TX
Mailing Address - Zip Code:78130-2151
Mailing Address - Country:US
Mailing Address - Phone:830-627-9878
Mailing Address - Fax:830-627-9879
Practice Address - Street 1:2115 STEPHENS PL STE 100
Practice Address - Street 2:
Practice Address - City:NEW BRAUNFELS
Practice Address - State:TX
Practice Address - Zip Code:78130-2151
Practice Address - Country:US
Practice Address - Phone:830-627-9878
Practice Address - Fax:830-627-9879
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL7154208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX159856701Medicaid