Fasola, Carlos G
Fasola, Carlos G is an individual health care provider with primary practice located at 1411 N Beckley Ave Pav Iii Ste#268, Dallas TX 75203-1259. He recently has only one registered license in Allopathic & Osteopathic Physicians / Transplant Surgery, which is considered as his primary health care specialty. Fasola, Carlos G can be contacted via phone (214) 947-4400.Contact Information
Primary practice address
1411 N Beckley Ave Pav Iii Ste#268
Dallas TX 75203-1259
Phone: (214) 947-4400
Fax: (214) 947-4404
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Transplant Surgery | 204F00000X | K7283 | Texas |
Profile Details
| NPI number | 1740463090 |
|---|---|
| LBN Legal business name | Fasola, Carlos G |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 10th, 2007 |
| Last updated | Dec 4th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1740463090 | NPPES |
| Texas | Other | 8DL222 | BLUE CROSS |
| Texas | MEDICAID | 040635703 | BLUE CROSS |
| Texas | MEDICAID | 040635704 | BLUE CROSS |
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