Provider Demographics
NPI:1568484327
Name:CARCAMO, GERARDO E (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARDO
Middle Name:E
Last Name:CARCAMO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:11212 STATE HWY 151
Mailing Address - Street 2:MEDICAL BLDG 2, 201
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251
Mailing Address - Country:US
Mailing Address - Phone:210-703-9440
Mailing Address - Fax:210-520-0378
Practice Address - Street 1:11212 STATE HWY 151
Practice Address - Street 2:MEDICAL BLD 2, 201
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251
Practice Address - Country:US
Practice Address - Phone:210-703-9440
Practice Address - Fax:210-520-0378
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2021-05-06
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXK4014208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG60893Medicare UPIN