Individual
CARLOS WADE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
139 COUNTRY VISTA CIR, BURLESON, TX 76028-7877
(325) 716-9182
(817) 568-5423
Mailing address
139 COUNTRY VISTA CIR, BURLESON, TX 76028-7877
(325) 716-9182
(817) 568-5423
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
M4631
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
183303001
—
TX
01
—
8V9831
BLUE CROSS
TX
Enumeration date
07/17/2006
Last updated
08/26/2022
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