Provider Demographics
NPI:1740802313
Name:DOSTAL, CARLOS RENE (MD, PHD)
Entity type:Individual
Prefix:
First Name:CARLOS
Middle Name:RENE
Last Name:DOSTAL
Suffix:
Gender:
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:UTMB DEPT OF INTERNAL MED
Mailing Address - Street 2:301 UNIVERSITY BLVD
Mailing Address - City:GALVESTON
Mailing Address - State:TX
Mailing Address - Zip Code:77555-0570
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:PRIMARY CARE PAVILION, SUITE 107
Practice Address - Street 2:400 HARBORSIDE DRIVE
Practice Address - City:GALVESTON
Practice Address - State:TX
Practice Address - Zip Code:77555-1167
Practice Address - Country:US
Practice Address - Phone:409-747-1883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-17
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXU3200207RA0401X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0401XAllopathic & Osteopathic PhysiciansInternal MedicineAddiction Medicine