Provider Demographics
NPI:1598878225
Name:CARRASCO, ARNULFO TARIN (MD)
Entity Type:Individual
Prefix:DR
First Name:ARNULFO
Middle Name:TARIN
Last Name:CARRASCO
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 1:4763 HAMILTON WOLFE RD STE 200
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78229-3329
Mailing Address - Country:US
Mailing Address - Phone:210-614-4825
Mailing Address - Fax:210-614-4525
Practice Address - Street 1:4763 HAMILTON WOLFE RD STE 200
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78229-3329
Practice Address - Country:US
Practice Address - Phone:210-614-4825
Practice Address - Fax:210-614-4525
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4217207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX089895902Medicaid
TX089895902Medicaid