Provider Demographics
NPI:1831645399
Name:MARTIN COLINDRES, CARLOS E (SA-C)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:E
Last Name:MARTIN COLINDRES
Suffix:
Gender:M
Credentials:SA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18211 BULVERDE RD APT 13207
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78259-3720
Mailing Address - Country:US
Mailing Address - Phone:510-574-6480
Mailing Address - Fax:
Practice Address - Street 1:18211 BULVERDE RD APT 13207
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78259-3720
Practice Address - Country:US
Practice Address - Phone:510-574-6480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-25
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical