Individual
CARMEN ELENA LANDAVERDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
607 CAMDEN ST STE 108, SAN ANTONIO, TX 78215-2100
(210) 253-3426
(210) 227-6951
Mailing address
1111 W 34TH ST, SUITE 210, AUSTIN, TX 78705-1900
(512) 454-8378
(512) 454-8375
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
N5797
TX
207RI0008X
Hepatology Physician
N5797
TX
207RT0003X
Transplant Hepatology Physician
Primary
N5797
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
217077101
—
TX
05
—
217077102
—
TX
01
—
8CH620
BCBSTX
TX
Enumeration date
10/01/2007
Last updated
05/30/2018
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