Doctor Name: | MRS. CAROLINE GAY CARR |
NPI Number: | 1083767693 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | PA07933 |
Business Practice Address: | 1313 Ranch Road 620 S Suite 201 Lakeway, TX - 787346316 |
Business Phone Number: | 5122630057 |
Business Fax Number: | 5122630221 |
Mailing Address: | 1313 Ranch Road 620 S, Suite 201 LAKEWAY |
State: | TX |
Postal Code: | 787346316 |
Phone Number: | 5122630057 |
Fax Number: | 5122630221 |
NPI Enumeration Date: | 01/18/2007 |
NPI Last Update Date: | 08/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA07933 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |