Provider Demographics
NPI:1609889138
Name:CARLOS ARAUZ PACHECO MD PA
Entity Type:Organization
Organization Name:CARLOS ARAUZ PACHECO MD PA
Other - Org Name:DIABETES AND ENDOCRINOLOGY CLINICAL CONSULTANTS OF TEXAS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARLOS
Authorized Official - Middle Name:
Authorized Official - Last Name:ARAUZ-PACHECO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:972-979-8237
Mailing Address - Street 1:890 ROCKWALL PKWY STE 102
Mailing Address - Street 2:
Mailing Address - City:ROCKWALL
Mailing Address - State:TX
Mailing Address - Zip Code:75032-6871
Mailing Address - Country:US
Mailing Address - Phone:972-475-5600
Mailing Address - Fax:972-475-5668
Practice Address - Street 1:890 ROCKWALL PKWY STE 102
Practice Address - Street 2:
Practice Address - City:ROCKWALL
Practice Address - State:TX
Practice Address - Zip Code:75032-6871
Practice Address - Country:US
Practice Address - Phone:972-475-5600
Practice Address - Fax:972-475-5668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-14
Last Update Date:2020-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ2481207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181723101Medicaid
TX181723101Medicaid