Individual
JOSE L CARRILLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
200 S VISTA RIDGE PKWY, CEDAR PARK, TX 78613-3901
(512) 570-1846
Mailing address
4109 WHITECREST CV, ROUND ROCK, TX 78681-1134
(512) 619-0237
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT2297
TX
Other
Enumeration date
04/21/2022
Last updated
04/21/2022
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