Provider Demographics
NPI:1659994069
Name:ANDRADE, CAROLINA A (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINA
Middle Name:A
Last Name:ANDRADE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 S MESA HILLS DR APT 3515
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79912-5157
Mailing Address - Country:US
Mailing Address - Phone:512-239-8988
Mailing Address - Fax:
Practice Address - Street 1:945 S MESA HILLS DR APT 3515
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79912-5157
Practice Address - Country:US
Practice Address - Phone:512-239-8988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27658833207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology