Individual
DR. MICHAEL JOHN CARRASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3901 W 15TH ST, PLANO, TX 75075-7738
(972) 758-3598
Mailing address
PO BOX 201606, DALLAS, TX 75320-1606
(972) 758-3598
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
L1813
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149178901
—
TX
05
—
149178902
—
TX
01
—
8A0479
BCBS
TX
01
—
8A9406
BCBS
TX
01
—
930115384
MEDICARE RAILROAD
TX
01
—
930117001
RAILROAD
TX
Enumeration date
12/13/2005
Last updated
03/01/2011
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