Provider Demographics
NPI:1639192370
Name:CHINEA, CARLOS ENRIQUE (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:ENRIQUE
Last Name:CHINEA
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 1:2700 CITIZENS PLZ STE 400
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77901-5757
Mailing Address - Country:US
Mailing Address - Phone:361-576-3277
Mailing Address - Fax:361-576-3271
Practice Address - Street 1:2700 CITIZENS PLZ STE 400
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901-5757
Practice Address - Country:US
Practice Address - Phone:361-576-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK8072207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX7906007OtherAETNA
TX8H8100OtherBCBS
TXH00257Medicare UPIN
TX7906007OtherAETNA
TX8A6035Medicare ID - Type UnspecifiedINDIVIDUAL