Individual
CARLOS BACINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6701 FANNIN ST, HOUSTON, TX 77030-2316
(832) 822-4280
(832) 825-4294
Mailing address
6701 FANNIN ST, HOUSTON, TX 77030-2316
(832) 822-4280
(832) 825-4294
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
J6069
TX
208000000X
Pediatrics Physician
Primary
J6069
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125817005
—
TX
Enumeration date
10/17/2006
Last updated
02/28/2011
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