Provider Demographics
NPI:1518490853
Name:SIZEMORE, CAROLINE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:
Last Name:SIZEMORE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6912 FM 1488 RD STE A
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-1527
Mailing Address - Country:US
Mailing Address - Phone:281-359-1945
Mailing Address - Fax:281-356-1978
Practice Address - Street 1:6912 FM 1488 RD STE A
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354
Practice Address - Country:US
Practice Address - Phone:281-356-1945
Practice Address - Fax:281-356-1978
Is Sole Proprietor?:No
Enumeration Date:2017-04-04
Last Update Date:2018-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA11205363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant