Individual
CARLOS VENEGAS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
500 N CLARENCE NASH BLVD, WATONGA, OK 73772-2845
(580) 623-7211
(580) 623-7233
Mailing address
500 N CLARENCE NASH BLVD, WATONGA, OK 73772-2845
(580) 623-7211
(580) 623-7233
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
116073
OK
363LF0000X
Family Nurse Practitioner
46245
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200590320A
—
KS
Enumeration date
09/08/2008
Last updated
01/06/2016
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