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Individual

CARLOS WILD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
520 E EUCLID AVE, SAN ANTONIO, TX 78212-4414
(210) 242-0020
Mailing address
102 YELLOWSTONE LAKE DR, LAREDO, TX 78041-1915
(727) 215-8177

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
817053
TX

Other

Enumeration date
08/02/2012
Last updated
05/13/2013
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