Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 1078376 | TX |
N | 2251E1200X | Ergonomics | 1078376 | TX |
N | 225XE1200X | Ergonomics | 1078376 | TX |
N | 2251S0007X | Physical Therapist - Sports | 1078376 | TX |
Y | 2251X0800X | Physical Therapist - Orthopedic | 1078376 | TX |
NPI | 1033159777 |
---|---|
Provider Name | Mr. Christopher D Carter |
First Address | Paris, TX 75462 |
Second Address | Paris, TX 75462 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2006 |
Last Update Date | 18/07/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
058540801 | (05) | TX |
100836070A | (05) | OK |
120488 | SUPERIOR PROVIDER NUMBER (01) | |
7223458 | AETNA PROVIDER NUMBER (01) | |
80810T | BCBS PROVIDER NUMBER (01) | TX |