Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | H1563 | TX |
N | 207RI0011X | Interventional Cardiology | H1563 | TX |
NPI | 1063407203 |
---|---|
Provider Name | Robert John Carney |
First Address | Tyler, TX 75701-5934 |
Second Address | Tyler, TX 75701-5934 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2005 |
Last Update Date | 03/08/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
038899308 | UNITED HEALTHCARE (01) | TX |
128691601 | (05) | TX |
452105 | AETNA (01) | TX |
89427J | BCBS OF TEXAS (01) | TX |
C14211 | (02) | |
P1578565 | OXFORD HEALTH PLANS (01) |