Provider Demographics
NPI:1568494672
Name:CARAG WEST, MYRNA (MD)
Entity Type:Individual
Prefix:
First Name:MYRNA
Middle Name:
Last Name:CARAG WEST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 S OCONNOR RD
Mailing Address - Street 2:
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75060
Mailing Address - Country:US
Mailing Address - Phone:972-254-5000
Mailing Address - Fax:972-254-2540
Practice Address - Street 1:219 S OCONNOR RD
Practice Address - Street 2:
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75060
Practice Address - Country:US
Practice Address - Phone:972-254-5000
Practice Address - Fax:972-254-2540
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF4781207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX00JF51Medicare ID - Type Unspecified
B21689Medicare UPIN