Provider Demographics
NPI:1437262045
Name:PRICE, CAROLYN E (DPT)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:E
Last Name:PRICE
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22715 WASHINGTON ST 102
Mailing Address - Street 2:
Mailing Address - City:LEONARDTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20650-3814
Mailing Address - Country:US
Mailing Address - Phone:301-997-0172
Mailing Address - Fax:301-997-0175
Practice Address - Street 1:4407 LITTLE RD STE 680
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76016-5628
Practice Address - Country:US
Practice Address - Phone:817-516-1115
Practice Address - Fax:817-516-1104
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2015-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1147001174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8T1098OtherBCBS PROVIDER NUMBER
TX676521Medicare ID - Type UnspecifiedMEDICARE NUMBER