Provider Demographics
NPI:1245409044
Name:DOWD, CAROLYN (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:CAROLYN
Middle Name:
Last Name:DOWD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1901 HIGHWAY 97 E STE 110
Mailing Address - Street 2:SOUTH TEXAS HEART CLINIC
Mailing Address - City:JOURDANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78026-1507
Mailing Address - Country:US
Mailing Address - Phone:830-769-3271
Mailing Address - Fax:830-769-3278
Practice Address - Street 1:1901 HIGHWAY 97 E STE 110
Practice Address - Street 2:SOUTH TEXAS HEART CLINIC
Practice Address - City:JOURDANTON
Practice Address - State:TX
Practice Address - Zip Code:78026-1507
Practice Address - Country:US
Practice Address - Phone:830-769-3271
Practice Address - Fax:830-769-3278
Is Sole Proprietor?:No
Enumeration Date:2008-02-26
Last Update Date:2009-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX195648401Medicaid
TX8K8859Medicare PIN