Provider Demographics
NPI:1467435982
Name:HERRERA, CARLOS ALBERTO (MD)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:ALBERTO
Last Name:HERRERA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:A
Other - Last Name:HERRERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 2975
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78502-2975
Mailing Address - Country:US
Mailing Address - Phone:956-362-2310
Mailing Address - Fax:956-362-2323
Practice Address - Street 1:2717 MICHAEL ANGELO
Practice Address - Street 2:STE 304
Practice Address - City:EDINBURG
Practice Address - State:TX
Practice Address - Zip Code:78539
Practice Address - Country:US
Practice Address - Phone:956-362-2310
Practice Address - Fax:956-362-2323
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ8573207VX0201X, 207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX131181310Medicaid
TX131181312Medicaid
TX131181312Medicaid
TXTXB128573Medicare PIN