Provider Demographics
NPI:1164430187
Name:CARTER, HARVEY LEE III (MD)
Entity Type:Individual
Prefix:MR
First Name:HARVEY
Middle Name:LEE
Last Name:CARTER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
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:214-775-2775
Mailing Address - Fax:214-750-1611
Practice Address - Street 1:5315 N CENTRAL EXPRESSWAY
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:214-775-2775
Practice Address - Fax:214-750-1611
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2017-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH1564207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX099843701Medicaid
TX180004462OtherRAILROAD MEDICARE
TX86V960OtherBCBS
TX180004462OtherRAILROAD MEDICARE
TX86V960Medicare PIN
C14250Medicare UPIN