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Brian Richard Carlson

NPI Registration Record

Provider / OrganizationNPIDate Certified
BRIAN RICHARD CARLSON12559860972020-06-27
Entity TypeIndividual
Provider Name Brian Richard Carlson
Practice Office Address5005 N. PIEDRAS ST.
EL PASO, TX US
Practice Office Telephone6143718434
Mailing Address2913 ROCKY RIDGE DR
EL PASO, TX 799042420 US
Business Telephone6143718434
HPT Codes
CodeLicense NoState
390200000X PRIMARY
OPI Codes

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