Individual
DR. CARLOS G FASOLA
Active
Individual
DR. CARLOS G FASOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
Primary
K7283
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040635703
—
TX
05
—
040635704
—
TX
01
—
8DL222
BLUE CROSS
TX
Enumeration date
12/10/2007
Last updated
12/04/2012
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