Provider Demographics
NPI:1346486008
Name:CAROLYN M. HYDE, M.D., P.A.
Entity Type:Organization
Organization Name:CAROLYN M. HYDE, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:M
Authorized Official - Last Name:HYDE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-970-4266
Mailing Address - Street 1:901 W 9TH ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78703-4630
Mailing Address - Country:US
Mailing Address - Phone:512-970-5266
Mailing Address - Fax:512-476-4310
Practice Address - Street 1:7200 N MO PAC EXPY
Practice Address - Street 2:SUITE 370
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3069
Practice Address - Country:US
Practice Address - Phone:512-970-5266
Practice Address - Fax:512-476-4310
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-31
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH3580207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty