Provider Demographics
NPI:1144328766
Name:CARSTENS, PAUL A (MD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:A
Last Name:CARSTENS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 MEADOWLAKES DR
Mailing Address - Street 2:
Mailing Address - City:MEADOWLAKES
Mailing Address - State:TX
Mailing Address - Zip Code:78654-6608
Mailing Address - Country:US
Mailing Address - Phone:830-265-4474
Mailing Address - Fax:830-265-6150
Practice Address - Street 1:105 MEADOWLAKES DR
Practice Address - Street 2:
Practice Address - City:MEADOWLAKES
Practice Address - State:TX
Practice Address - Zip Code:78654-6608
Practice Address - Country:US
Practice Address - Phone:830-265-4474
Practice Address - Fax:830-265-6150
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3556208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8360N1Medicare PIN
TX8H8402OtherBCBS
TX129603004Medicaid
TX129603001Medicaid
TX82991KMedicare PIN
TX83019KMedicare PIN