Provider Demographics
NPI:1578707501
Name:LUGO-ZAMUDIO, CARLOS EDUARDO (MD)
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:EDUARDO
Last Name:LUGO-ZAMUDIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CARLOS
Other - Middle Name:E
Other - Last Name:LUGO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1002 LAKEWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75070-5216
Mailing Address - Country:US
Mailing Address - Phone:214-629-2831
Mailing Address - Fax:
Practice Address - Street 1:814 HILLS CREEK DR
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-5230
Practice Address - Country:US
Practice Address - Phone:214-629-2831
Practice Address - Fax:972-547-9405
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-21
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE1367207U00000X, 207UN0902X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207U00000XAllopathic & Osteopathic PhysiciansNuclear Medicine
No207UN0902XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Imaging & Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXE08960Medicare UPIN