| Doctor Name: | CARLOS VENEGAS |
| NPI Number: | 1518115161 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | ARNP |
| License Number: | 46245 |
| Business Practice Address: | 500 N Clarence Nash Blvd Watonga, OK - 737722845 |
| Business Phone Number: | 5806237211 |
| Business Fax Number: | 5806237233 |
| Mailing Address: | 500 N Clarence Nash Blvd, WATONGA |
| State: | OK |
| Postal Code: | 737722845 |
| Phone Number: | 5806237211 |
| Fax Number: | 5806237233 |
| NPI Enumeration Date: | 09/08/2008 |
| NPI Last Update Date: | 01/06/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 46245 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | KS |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |