Provider Demographics
NPI:1275891632
Name:CARAM, BIANCA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:BIANCA
Middle Name:MARIE
Last Name:CARAM
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 1:712 N WASHINGTON AVE
Mailing Address - Street 2:STE 250
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75246-3926
Mailing Address - Country:US
Mailing Address - Phone:214-515-9001
Mailing Address - Fax:214-515-9004
Practice Address - Street 1:712 N WASHINGTON AVE STE 250
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75246-1631
Practice Address - Country:US
Practice Address - Phone:214-515-9001
Practice Address - Fax:214-515-9004
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-24
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX566960207V00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX364103701Medicaid