Active NPI
Alfonso Ismael Carrasco
- Chiropractor
- El Paso, TX
National Provider Identifier
1366710576
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 10763
- Practice address
- 11212 Montwood Dr
El Paso, TX 79936-4241 - Phone
- (915) 590-9355
- NPI assigned
- Dec 2, 2011
- Last updated
- Dec 2, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 10763 | TX | Primary |
Addresses
Primary practice location
11212 Montwood Dr
El Paso, TX 79936-4241
Mailing address
3940 Breckenridge Dr
El Paso, TX 79936-1206
Phone (915) 629-0263
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10763 | TX | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322784000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322784000000",
"number": "1366710576",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3940 BRECKENRIDGE DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799361206",
"telephone_number": "915-629-0263",
"fax_number": "915-594-0863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11212 MONTWOOD DR",
"city": "EL PASO",
"state": "TX",
"postal_code": "799364241",
"telephone_number": "915-590-9355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARRASCO",
"first_name": "ALFONSO",
"middle_name": "ISMAEL",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-12-02",
"last_updated": "2011-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "TX",
"license": "10763",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.