Provider Demographics
NPI:1508130501
Name:CARR, CELINA (PAC)
Entity Type:Individual
Prefix:
First Name:CELINA
Middle Name:
Last Name:CARR
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5208 N 10TH ST # 239
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-2701
Mailing Address - Country:US
Mailing Address - Phone:956-683-8700
Mailing Address - Fax:956-683-9440
Practice Address - Street 1:401 S ALAMO RD
Practice Address - Street 2:
Practice Address - City:ALAMO
Practice Address - State:TX
Practice Address - Zip Code:78516-2501
Practice Address - Country:US
Practice Address - Phone:956-787-9111
Practice Address - Fax:956-683-9440
Is Sole Proprietor?:No
Enumeration Date:2012-03-08
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA07768363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1103559OtherNCCPA