Provider Demographics
NPI:1598953515
Name:CARLOS M LLANES, MD
Entity Type:Organization
Organization Name:CARLOS M LLANES, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:M
Authorized Official - Last Name:LLANES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:956-795-4770
Mailing Address - Street 1:PO BOX 2926
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78044-2926
Mailing Address - Country:US
Mailing Address - Phone:956-795-4770
Mailing Address - Fax:
Practice Address - Street 1:1519 E BUSTAMANTE ST
Practice Address - Street 2:STE E
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-5305
Practice Address - Country:US
Practice Address - Phone:956-795-4770
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-04
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH4019207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX152163501Medicaid
TX00503TMedicare PIN