Individual
KEVIN CARRERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7111 PARKLAND DR, EL PASO, TX 79925-3744
(915) 637-5790
Mailing address
7111 PARKLAND DR, EL PASO, TX 79925-3744
(915) 637-5790
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
919088
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
919088
—
TX
Enumeration date
03/01/2018
Last updated
03/01/2018
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