Provider Demographics
NPI:1255674487
Name:CARROLL, CAITLIN (MD)
Entity Type:Individual
Prefix:
First Name:CAITLIN
Middle Name:
Last Name:CARROLL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18350 TIMBER FOREST DR
Mailing Address - Street 2:STE. 100
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-2957
Mailing Address - Country:US
Mailing Address - Phone:281-446-2196
Mailing Address - Fax:281-446-4103
Practice Address - Street 1:18350 TIMBER FOREST DR
Practice Address - Street 2:STE. 100
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-2957
Practice Address - Country:US
Practice Address - Phone:281-446-2196
Practice Address - Fax:281-446-4103
Is Sole Proprietor?:No
Enumeration Date:2013-04-06
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ8032208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics