Provider Demographics
NPI:1629196704
Name:CARRION, JOSE OSCAR (LSA)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:OSCAR
Last Name:CARRION
Suffix:
Gender:M
Credentials:LSA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10723 CANMERE CT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-4795
Mailing Address - Country:US
Mailing Address - Phone:713-401-8742
Mailing Address - Fax:713-401-8742
Practice Address - Street 1:10723 CANMERE CT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-4795
Practice Address - Country:US
Practice Address - Phone:713-401-8742
Practice Address - Fax:713-401-8742
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXSA00331363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical