Provider Demographics
NPI:1467468165
Name:CARROLL, L NATALIE (MD P A)
Entity Type:Individual
Prefix:DR
First Name:L
Middle Name:NATALIE
Last Name:CARROLL
Suffix:
Gender:F
Credentials:MD P A
Other - Prefix:DR
Other - First Name:LAVERNE
Other - Middle Name:NATALIE
Other - Last Name:CARROLL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD P A
Mailing Address - Street 1:5445 ALMEDA RD
Mailing Address - Street 2:STE 201
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7434
Mailing Address - Country:US
Mailing Address - Phone:716-667-3999
Mailing Address - Fax:713-522-2247
Practice Address - Street 1:5445 ALMEDA RD
Practice Address - Street 2:STE 201
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7434
Practice Address - Country:US
Practice Address - Phone:716-667-3999
Practice Address - Fax:713-522-2247
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2016-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF2586207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX123588901Medicaid
TX1467468165OtherNPI
TX500840ZUUMedicare PIN