Provider Demographics
NPI:1376500488
Name:JAPAS, CARLOS A (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:A
Last Name:JAPAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11807 S FREEWAY
Mailing Address - Street 2:STE 360
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76115-0337
Mailing Address - Country:US
Mailing Address - Phone:817-551-0445
Mailing Address - Fax:817-551-0629
Practice Address - Street 1:11807 S FREEWAY
Practice Address - Street 2:STE 360
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76115-0337
Practice Address - Country:US
Practice Address - Phone:817-551-0445
Practice Address - Fax:817-551-0629
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2016-12-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXH2142207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX032778501Medicaid
00DH28Medicare ID - Type Unspecified
C17411Medicare UPIN