Provider Demographics
NPI:1619082054
Name:CRIBBS, CAREY B (MD)
Entity Type:Individual
Prefix:
First Name:CAREY
Middle Name:B
Last Name:CRIBBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 733784
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75373-3784
Mailing Address - Country:US
Mailing Address - Phone:682-885-1855
Mailing Address - Fax:682-885-1396
Practice Address - Street 1:801 7TH AVE
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-2733
Practice Address - Country:US
Practice Address - Phone:682-885-4095
Practice Address - Fax:682-885-7499
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2021-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXH0272207PP0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PP0204XAllopathic & Osteopathic PhysiciansEmergency MedicinePediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX10028692OtherAMERIGROUP PIN
TX136530608Medicaid
TX137283103Medicaid
1669442042OtherGRP NPI NUMBER
TX9454181OtherCIGNA PIN
TX137345805Medicaid
TX1392631OtherUHC PIN
TX1640310OtherFIRSTHEALTH PIN
TX00L42VOtherBCBSTX GRP PIN
TX101412OtherSUPERIOR PIN
TX136530606Medicaid
TX4611050OtherAETNA PIN
TX88V500OtherBCBSTX IND PIN
TX110996100OtherFIRSTCARE PIN
TX1392631OtherUHC PIN
E80080Medicare UPIN
TX00L42VMedicare PIN