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Individual

DR. CARSON COPE PETRASH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
21 SPURS LN, SAN ANTONIO, TX 78240-1669
(800) 833-5921
(713) 513-5613
Mailing address
21 SPURS LN, SAN ANTONIO, TX 78240-1669
(800) 833-5921
(713) 513-5613

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
U4600
TX
207WX0107X
Retina Specialist (Ophthalmology) Physician
U4600
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
36379873
TEXAS DRIVERS LICENSE
TX
Enumeration date
04/03/2018
Last updated
04/28/2025
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