Provider Demographics
NPI:1679764252
Name:PRADERIO, CAROLINA (MD)
Entity type:Individual
Prefix:
First Name:CAROLINA
Middle Name:
Last Name:PRADERIO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5826 ESPLANADE DR STE 101
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78414-4208
Mailing Address - Country:US
Mailing Address - Phone:361-991-9356
Mailing Address - Fax:844-717-5672
Practice Address - Street 1:5826 ESPLANADE DR STE 101
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78414-4208
Practice Address - Country:US
Practice Address - Phone:361-991-9356
Practice Address - Fax:844-717-5672
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN7573207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX282426001Medicaid
TX282426001Medicaid