Provider Demographics
NPI:1437149655
Name:REMIREZ, CARLOS MANUEL (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:MANUEL
Last Name:REMIREZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6024 AZTEC RD
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-2011
Mailing Address - Country:US
Mailing Address - Phone:915-594-7787
Mailing Address - Fax:915-598-3365
Practice Address - Street 1:6024 AZTEC RD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-2011
Practice Address - Country:US
Practice Address - Phone:915-594-7787
Practice Address - Fax:915-598-3365
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2008-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG7869207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1297038 05Medicaid
TX129703808Medicaid
TX129703809Medicaid
NM80888364Medicaid
TX1297038 05Medicaid
TX8J8166Medicare PIN
TX129703808Medicaid
TX8K1073Medicare PIN