Individual
MS. EILEEN CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FA
Contact information
Practice address
3463 MAGIC DR STE T21, SAN ANTONIO, TX 78229-3621
(210) 614-8101
Mailing address
12107 RIDGE SUMMIT ST, SAN ANTONIO, TX 78247-3405
(210) 643-1148
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
17-563
TX
Other
Enumeration date
11/28/2017
Last updated
11/28/2017
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