Provider Demographics
NPI:1184608028
Name:TORRES, CARLOS MANUEL (MD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:MANUEL
Last Name:TORRES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:CARLOS
Other - Middle Name:MANUEL
Other - Last Name:TORRES MARCOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:330 LAS COLINAS BLVD E
Mailing Address - Street 2:SUITE 1316
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75039-5510
Mailing Address - Country:US
Mailing Address - Phone:972-816-3928
Mailing Address - Fax:
Practice Address - Street 1:330 LAS COLINAS BLVD E
Practice Address - Street 2:SUITE 1316
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75039-5510
Practice Address - Country:US
Practice Address - Phone:972-816-3928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-05
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0063268207ZP0102X
LA15171R207ZP0102X
FLME94401207ZP0102X
MOUNKNOWN207ZP0102X
CT043349207ZP0102X
CODR-43589207ZP0102X
TN40329207ZP0102X
SC27857207ZP0102X
PAMD057476L207ZP0102X
NV10219207ZP0102X
NMTM2005-0618207ZP0102X
NC2005-01193207ZP0102X
TXK5230207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX042632206Medicaid
TX42632203Medicaid
TX8203M5OtherBCBS
TX8203M5Medicare ID - Type Unspecified