Provider Demographics
NPI:1023021284
Name:HARVEY L CARTER III MD PA
Entity Type:Organization
Organization Name:HARVEY L CARTER III MD PA
Other - Org Name:CARTER EYE CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:MACKNIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-775-2770
Mailing Address - Street 1:5315 N CENTRAL EXPY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-3319
Mailing Address - Country:US
Mailing Address - Phone:214-750-1962
Mailing Address - Fax:214-750-7253
Practice Address - Street 1:5315 N CENTRAL EXPY
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-3319
Practice Address - Country:US
Practice Address - Phone:214-750-1962
Practice Address - Fax:214-750-7253
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-15
Last Update Date:2009-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX083771801Medicaid
00L53SOtherBCBS
TX00L53SMedicare PIN
00L53SOtherBCBS