| Organization Name: | CARLOS A DIMIDJIAN |
| NPI Number: | 1255519229 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARLOS A DIMIDJIAN (OWNER) |
| Mailing Address: | 1608 W Fm 700 Ste B Big Spring |
| State: | TX US |
| Postal Code: | 797204113 |
| Phone Number: | 4322671441 |
| Fax Number: | 4322671442 |
| NPI Enumeration Date: | 02/01/2008 |
| NPI Last Update Date: | 06/09/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 213ES0131X |
| License Number: | TX0935 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Podiatric Medicine & Surgery Service Providers |
| Taxonomy Classification: | Podiatrist |
| Taxonomy Specialization: | Foot Surgery |
| Taxonomy Definition: | |