Provider Demographics
NPI:1386686459
Name:JONES, CARRIE LANGSTON (MD)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:LANGSTON
Last Name:JONES
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:PO BOX 99371
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76199-0371
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-7347
Practice Address - Street 1:306 HIGHWAY 377 N STE H
Practice Address - Street 2:
Practice Address - City:ARGYLE
Practice Address - State:TX
Practice Address - Zip Code:76226-3958
Practice Address - Country:US
Practice Address - Phone:940-898-1477
Practice Address - Fax:940-382-4091
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM0119208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX178667501Medicaid
TX8G4635Medicare ID - Type Unspecified
TXI51469Medicare UPIN