Organization
CARL D'AGOSTINO M.D., LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARL D'AGOSTINO M.D. (PARTNER)
(432) 620-8888
Entity
Organization
Contact information
Practice address
2407 W LOUISIANA AVE, SUITE 101, MIDLAND, TX 79701-5807
(432) 620-8888
(432) 620-8187
Mailing address
2407 W LOUISIANA AVE, SUITE 101, MIDLAND, TX 79701-5807
(432) 620-8888
(432) 620-8187
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
J7460
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0050EA
BLUE CROSS BLUE SHIELD
TX
01
—
5541135
AETNA
TX
Enumeration date
02/05/2007
Last updated
08/22/2020
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