Individual
CARLOS A PRENDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5005 S 153RD ST, SUITE 100, OMAHA, NE 68137-5069
(402) 717-9100
(402) 717-9101
Mailing address
PO BOX 642117, OMAHA, NE 68164-8117
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21619
NE
207Q00000X
Family Medicine Physician
48150
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
26503573
—
CO
Enumeration date
08/31/2006
Last updated
10/19/2011
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