Provider Demographics
NPI:1932131794
Name:CARRILLO, ARTURO (MD)
Entity Type:Individual
Prefix:
First Name:ARTURO
Middle Name:
Last Name:CARRILLO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 PORT LANE
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:806-358-4839
Mailing Address - Fax:806-358-4899
Practice Address - Street 1:1911 PORT LANE
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:806-358-4839
Practice Address - Fax:806-358-4899
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF0144207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
00BD94OtherBLUE CROSS BLUE SHIELD
109944100OtherFIRSTCARE
109944100OtherSOUTHWEST LIFE & HEALTH
160006233OtherRAILROAD MEDICARE
00BD94OtherBLUE CROSS BLUE SHIELD
109944100OtherSOUTHWEST LIFE & HEALTH