Provider Demographics
NPI:1417987983
Name:CARTER, SHELBY H III (MD)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:H
Last Name:CARTER
Suffix:III
Gender:M
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 26726
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78755-0726
Mailing Address - Country:US
Mailing Address - Phone:512-407-8686
Mailing Address - Fax:512-421-4489
Practice Address - Street 1:1301 W 38TH ST STE 102
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-1010
Practice Address - Country:US
Practice Address - Phone:512-454-4561
Practice Address - Fax:512-467-2906
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2022-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH9048207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX094771502Medicaid
TX132346107Medicaid
TX817425OtherBCBS
TX4293049OtherAETNA TRS
TX91043OtherSCOTT & WHITE
TXE56752Medicare ID - Type UnspecifiedMEDICARE PART B
TXTXB105019Medicare PIN
TX817425OtherBCBS
TXP00882100Medicare PIN
TX094771502Medicaid