Provider Demographics
NPI:1689786238
Name:QUIROZ, CARLOS A (DO)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:A
Last Name:QUIROZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20306 ENCINO LEDGE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-3918
Mailing Address - Country:US
Mailing Address - Phone:210-402-0138
Mailing Address - Fax:210-402-0051
Practice Address - Street 1:20306 ENCINO LEDGE
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259
Practice Address - Country:US
Practice Address - Phone:210-402-0138
Practice Address - Fax:210-402-0051
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXK3632208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0075CLOtherBCBS
TX092309601Medicaid
TX092309602Medicaid
TX092309602Medicaid