Provider Demographics
NPI:1396991113
Name:PEREZ-COSIO, CARLOS (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:
Last Name:PEREZ-COSIO
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 1:8906 SPANISH RIDGE AVE
Mailing Address - Street 2:STE. 202
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89148-1304
Mailing Address - Country:US
Mailing Address - Phone:702-577-1622
Mailing Address - Fax:702-912-4994
Practice Address - Street 1:1950 PINTO LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89106-4017
Practice Address - Country:US
Practice Address - Phone:702-438-2229
Practice Address - Fax:702-385-0982
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV13261207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV13261OtherNV MEDICAL LICENSE
NV1396991113Medicaid
TXR3179OtherTX MEDICAL LICENSE
NV13261OtherNV MEDICAL LICENSE