Eileen Carrillo, FA

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

17-563 Issued in TX

Practice address

3463 Magic Dr Ste T21
San Antonio, TX 78229-3621

Phone

(210) 614-8101

NPI assigned

Nov 28, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511827200000",
    "number": "1659885705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12107 RIDGE SUMMIT ST",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782473405",
            "telephone_number": "210-643-1148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3463 MAGIC DR STE T21",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782293621",
            "telephone_number": "210-614-8101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRILLO",
        "first_name": "EILEEN",
        "name_prefix": "Ms.",
        "credential": "FA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-28",
        "last_updated": "2017-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Surgery",
            "state": "TX",
            "license": "17-563",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mariana Carrillo Salais
• Amistie Carrillo
• Belen Iridian Carrillo
• Bianca Vanessa Carrillo, M.A., CCC-SLP, CDP
• Caleb Carrillo
• Erika Carrillo
• Haylee Marie Carrillo
• Javier Carrillo
• Jazmine Carrillo, CNP
• Kristi Carrillo, COTA/L

• Surgery Physician in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Surgery Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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.