| Doctor Name: | MR. CARL AUSTIN WILLEFORD JR. |
| NPI Number: | 1063465409 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | FNP-C |
| License Number: | 631071 |
| Business Practice Address: | 2418 W Main St Gun Barrel City, TX - 751563638 |
| Business Phone Number: | 9038873736 |
| Business Fax Number: | |
| Mailing Address: | 1082 Oak Bend Dr, KAUFMAN |
| State: | TX |
| Postal Code: | 751425338 |
| Phone Number: | 9729620490 |
| Fax Number: | |
| NPI Enumeration Date: | 05/18/2006 |
| NPI Last Update Date: | 03/13/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 631071 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |