Provider Demographics
NPI:1144281445
Name:GODINEZ, CARLOS DRAEGER JR (MD)
Entity type:Individual
Prefix:DR
First Name:CARLOS
Middle Name:DRAEGER
Last Name:GODINEZ
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:414 NAVARRO
Mailing Address - Street 2:SUITE 1420
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78205
Mailing Address - Country:US
Mailing Address - Phone:210-804-2020
Mailing Address - Fax:210-519-3184
Practice Address - Street 1:414 NAVARRO
Practice Address - Street 2:SUITE 816
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78205
Practice Address - Country:US
Practice Address - Phone:210-804-2020
Practice Address - Fax:210-519-3184
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2014-11-11
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Provider Licenses
StateLicense IDTaxonomies
MDD0066078208600000X
CAAFE63478208600000X
TXP6622208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery