Provider Demographics
NPI:1497793459
Name:MORRILL, AUDREY CARR (M,D,)
Entity Type:Individual
Prefix:
First Name:AUDREY
Middle Name:CARR
Last Name:MORRILL
Suffix:
Gender:F
Credentials:M,D,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2665 SCRIPTURE ST
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76201-2302
Mailing Address - Country:US
Mailing Address - Phone:940-387-8763
Mailing Address - Fax:940-387-8889
Practice Address - Street 1:2665 SCRIPTURE ST
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76201-2302
Practice Address - Country:US
Practice Address - Phone:940-387-8763
Practice Address - Fax:940-387-8889
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2016-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2080207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX030751403OtherMEDICAID OTHER
TX030751402Medicaid
TXP00335091OtherRAILROAD MEDICARE
TXP00335091OtherRAILROAD MEDICARE
TX030751402Medicaid