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Individual

IRENE ANNE CARRILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BS RN CPN

Contact information

Practice address
3800 CLINTON LN, LAGO VISTA, TX 78645-7919
(512) 267-3533
Mailing address
3800 CLINTON LN, LAGO VISTA, TX 78645-7919
(512) 267-3533

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
559942
TX

Other

Enumeration date
06/26/2018
Last updated
06/26/2018
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