Provider Demographics
NPI:1801802152
Name:NAVARRO, CARLOS F (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:F
Last Name:NAVARRO
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 1:706 W BEN WHITE BLVD BLDG A
Mailing Address - Street 2:STE 100
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-7034
Mailing Address - Country:US
Mailing Address - Phone:512-442-1996
Mailing Address - Fax:512-441-1093
Practice Address - Street 1:706 W BEN WHITE BLVD BLDG A
Practice Address - Street 2:STE 100
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7034
Practice Address - Country:US
Practice Address - Phone:512-442-1996
Practice Address - Fax:512-441-1093
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2016-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0837207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX174347802Medicaid
TX174347803Medicaid
TXTXB155452OtherWELLMED PTAN
TX174347801Medicaid
TXP00300156Medicare PIN
TXTXB155452OtherWELLMED PTAN
TX174347803Medicaid