Provider Demographics
NPI:1760770028
Name:ROJAS, CARLTON J (NP)
Entity Type:Individual
Prefix:MR
First Name:CARLTON
Middle Name:J
Last Name:ROJAS
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 846098
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75284-6098
Mailing Address - Country:US
Mailing Address - Phone:903-324-6400
Mailing Address - Fax:
Practice Address - Street 1:800 E DAWSON ST
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75701-2036
Practice Address - Country:US
Practice Address - Phone:903-525-1914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP120648363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX288249020Medicaid
TX8461NYOtherBCBS
TXP01719544OtherRAIL ROAD MEDICARE
TXP01502514OtherRAIL ROAD
TX710892OtherTX NURSING LICENSE
TX288249013Medicaid
TX75-0818167-048OtherTRICARE
TX8012NQOtherBCBS
TX8460NYOtherBCBS
TX288249015Medicaid
TX288249021Medicaid
TX75-1976930-005OtherTRICARE
TX75-2616977-042OtherTRICARE
TXP01731691OtherRAIL ROAD MEDICARE
TX279774YS6VMedicare PIN
TX8460NYOtherBCBS
TX288249021Medicaid
TX288249013Medicaid