Juan Luis Carriedo, BS CNMT

Primary specialty

Nuclear Medicine PhysicianTaxonomy code 207U00000X

License

023457 Issued in TX

Practice address

623 Kampmann Blvd
San Antonio, TX 78201-4834

Phone

(210) 701-8987

NPI assigned

Nov 25, 2024

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1732492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1093531014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "623 KAMPMANN BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782014834"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "623 KAMPMANN BLVD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782014834",
            "telephone_number": "210-701-8987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRIEDO",
        "first_name": "JUAN",
        "middle_name": "LUIS",
        "credential": "BS CNMT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-25",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0901X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Cardiology",
            "state": "TX",
            "license": "023457",
            "primary": false
        },
        {
            "code": "207U00000X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine",
            "state": "TX",
            "license": "023457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benito Carrera Leal, MD
• Jillian Ann Carrera
• Freddy Jose Carreras Alvarado, M.D.
• Carlos R Carretero, M.D.
• Edgar Heberto Carretero, M.D.
• Patricia Carrillo Barnes, MS LPC LMFT
• Levi Uziel Carrillo Flores
• Zaide Alexa Carrillo Flores, RBT
• Mariana Carrillo Salais
• Amistie Carrillo

• Nuclear Medicine Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Nuclear Medicine Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.