Basic Information
Provider Information
NPI: 1588605885
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARANGO
FirstName: CARMEN
MiddleName: PEREZ
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5959 GATEWAY WEST
Address2: STE 120
City: EL PASO
State: TX
PostalCode: 799253315
CountryCode: US
TelephoneNumber: 9157791716
FaxNumber: 9157791754
Practice Location
Address1: 643A S MESA HILLS DRIVE
Address2:  
City: EL PASO
State: TX
PostalCode: 799125540
CountryCode: US
TelephoneNumber: 9158567533
FaxNumber: 9152172689
Other Information
ProviderEnumerationDate: 06/09/2006
LastUpdateDate: 03/07/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202XJ0426TXY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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