Provider Demographics
NPI:1417962960
Name:ARGUELLES, CARLOS ANTONIO
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:ANTONIO
Last Name:ARGUELLES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:A
Other - Last Name:ARGUELLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 912215
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80291-2215
Mailing Address - Country:US
Mailing Address - Phone:303-306-7783
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:1024 S LEMAY AVE
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524
Practice Address - Country:US
Practice Address - Phone:303-306-7783
Practice Address - Fax:303-306-7753
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2002-0006207P00000X
CO46198207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO90371861Medicaid
NM53307321Medicaid
COCOA103218Medicare PIN
NM53307321Medicaid
H69679Medicare UPIN