Provider Demographics
NPI:1154393577
Name:ARAZOZA, ANTONIO CARLOS (MD)
Entity type:Individual
Prefix:
First Name:ANTONIO
Middle Name:CARLOS
Last Name:ARAZOZA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 W COLORADO BLVD
Mailing Address - Street 2:PAV II STE#425
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75208-2312
Mailing Address - Country:US
Mailing Address - Phone:214-947-3684
Mailing Address - Fax:214-947-3686
Practice Address - Street 1:221 W COLORADO BLVD
Practice Address - Street 2:PAV II STE#425
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2312
Practice Address - Country:US
Practice Address - Phone:214-947-3684
Practice Address - Fax:214-947-3686
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3719207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX042411102Medicaid
TX042411102Medicaid