Provider Demographics
NPI:1164422440
Name:CARTER, DAVID JAMES (MD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:JAMES
Last Name:CARTER
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 1:1615 HOSPITAL PKWY
Mailing Address - Street 2:SUITE 211
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-5934
Mailing Address - Country:US
Mailing Address - Phone:817-545-6118
Mailing Address - Fax:817-684-8333
Practice Address - Street 1:1615 HOSPITAL PKWY
Practice Address - Street 2:SUITE 211
Practice Address - City:BEDFORD
Practice Address - State:TX
Practice Address - Zip Code:76022-5934
Practice Address - Country:US
Practice Address - Phone:817-545-6118
Practice Address - Fax:817-684-8333
Is Sole Proprietor?:No
Enumeration Date:2005-07-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT57640208G00000X
TXF3815208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
D97269Medicare UPIN