Individual
DR. CARL G W DAHLBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
COLUMBUS MEDICAL CLINIC, 2122 HWY 71 S, COLUMBUS, TX 78934
(979) 732-2318
(979) 732-2310
Mailing address
DEPT 794, PO BOX 4346, HOUSTON, TX 77210-4346
(713) 255-4000
(713) 255-4050
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
H3559
TX
207RP1001X
Pulmonary Disease Physician
Primary
H3559
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102112303
—
TX
01
—
4104575
AETNA PROVIDER #
TX
01
—
8R1141
BLUE CROSS PROV #
TX
01
—
P00184430
RAILROAD MEDICARE NUMBER
TX
Enumeration date
05/19/2006
Last updated
09/20/2023
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