Individual
DR. CARLOS NIETO JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
701 W 5TH ST, ODESSA, TX 79763-4206
(432) 335-1500
(432) 335-1537
Mailing address
701 W 5TH ST, ODESSA, TX 79763-4206
(432) 335-1500
(432) 335-1537
Taxonomy
Speciality
Code
Description
License number
State
2080N0001X
Neonatal-Perinatal Medicine Physician
E4567
TX
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
E4567
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8896J2
BCBS
TX
Enumeration date
03/07/2007
Last updated
09/11/2025
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