Provider Demographics
NPI:1255388203
Name:TIRADO, CARLOS FRANCISCO (MD, MPH)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:FRANCISCO
Last Name:TIRADO
Suffix:
Gender:M
Credentials:MD, MPH
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 160996
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78716-0996
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:888-871-7696
Practice Address - Street 1:440 FISCHER STORE RD
Practice Address - Street 2:
Practice Address - City:WIMBERLEY
Practice Address - State:TX
Practice Address - Zip Code:78676-6158
Practice Address - Country:US
Practice Address - Phone:512-847-6179
Practice Address - Fax:888-871-7696
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL26992084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX181084802Medicaid
TX8CT529OtherBCBS
TXTXB129772Medicare PIN