Provider Demographics
NPI:1114588696
Name:CARRELL CLINIC SPECIALTY CARE PLLC
Entity Type:Organization
Organization Name:CARRELL CLINIC SPECIALTY CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:B
Authorized Official - Last Name:DOSSETT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:214-220-2468
Mailing Address - Street 1:9301 N CENTRAL EXPY STE 400
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-0805
Mailing Address - Country:US
Mailing Address - Phone:214-529-2057
Mailing Address - Fax:214-953-1210
Practice Address - Street 1:9301 N CENTRAL EXPY STE 400
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-0805
Practice Address - Country:US
Practice Address - Phone:214-529-2057
Practice Address - Fax:214-953-1210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-25
Last Update Date:2019-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty