Basic Information
Provider Information
NPI: 1861735128
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CARRERAS
FirstName: YULY
MiddleName: DOTEL
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3750 COMMERCIAL AVE
Address2:  
City: SAN ANTONIO
State: TX
PostalCode: 782213117
CountryCode: US
TelephoneNumber: 2109227000
FaxNumber: 8306299367
Practice Location
Address1: 1034 W COUNTY LINE RD
Address2:  
City: NEW BRAUNFELS
State: TX
PostalCode: 781308338
CountryCode: US
TelephoneNumber: 2109227000
FaxNumber: 8306299367
Other Information
ProviderEnumerationDate: 04/04/2013
LastUpdateDate: 04/23/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/23/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000XP6953TXY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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