Individual
DR. CARLOS R VAZQUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2211 S BURNSIDE AVE, STE 4, GONZALES, LA 70737-4634
(225) 647-1947
Mailing address
PO BOX 1117, GONZALES, LA 70707-1117
(225) 647-1947
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
022083
LA
207UN0901X
Nuclear Cardiology Physician
022083
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1495859
—
LA
Enumeration date
06/29/2006
Last updated
08/22/2016
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