Provider Demographics
NPI:1891980553
Name:CARRASCO & CARRASCO, LLP
Entity Type:Organization
Organization Name:CARRASCO & CARRASCO, LLP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:B
Authorized Official - Last Name:CARRASCO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:806-359-9100
Mailing Address - Street 1:1911 PORT LN STE 2
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2470
Mailing Address - Country:US
Mailing Address - Phone:806-359-9100
Mailing Address - Fax:806-359-7022
Practice Address - Street 1:1911 PORT LN STE 2
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2470
Practice Address - Country:US
Practice Address - Phone:806-359-9100
Practice Address - Fax:806-359-7022
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-06
Last Update Date:2013-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXJ1914174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX84861SOtherBLUECROSS BLUE SHIELD
84860SOtherBLUE CROSS BLUE SHIELD
TXG32285Medicare UPIN
84860SOtherBLUE CROSS BLUE SHIELD
TXP0005BE9Medicare PIN