Provider Demographics
NPI:1679528376
Name:FERRARI, CARLOS A
Entity Type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:A
Last Name:FERRARI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 GESSNER
Mailing Address - Street 2:SUITE 375
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77024-0000
Mailing Address - Country:US
Mailing Address - Phone:713-864-5487
Mailing Address - Fax:713-864-4872
Practice Address - Street 1:915 GESSNER
Practice Address - Street 2:SUITE 375
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77024-0000
Practice Address - Country:US
Practice Address - Phone:713-864-5487
Practice Address - Fax:713-864-4872
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-23
Last Update Date:2010-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG6293208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXFD28OtherBLUE CROSS BLUE SHIELD
TX033294201Medicaid
TXB87797Medicare UPIN
TX033294201Medicaid
TX00FD28Medicare PIN