Provider Demographics
NPI:1356503544
Name:CARTER, DORNECHIA ELVERNA GEORGE (MD)
Entity Type:Individual
Prefix:DR
First Name:DORNECHIA
Middle Name:ELVERNA GEORGE
Last Name:CARTER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:13136 DALLAS PKWY STE 520
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75033-4247
Mailing Address - Country:US
Mailing Address - Phone:469-480-8100
Mailing Address - Fax:469-480-8101
Practice Address - Street 1:13136 DALLAS PKWY STE 520
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75033-4247
Practice Address - Country:US
Practice Address - Phone:469-480-8100
Practice Address - Fax:469-480-8101
Is Sole Proprietor?:No
Enumeration Date:2008-06-28
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXN8896207N00000X
WI54082-020207N00000X, 207NI0002X
TXBP20029580207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NI0002XAllopathic & Osteopathic PhysiciansDermatologyClinical & Laboratory Dermatological Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI730550005Medicare PIN