Provider Demographics
NPI:1619975844
Name:BATTY, CAROL A (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:A
Last Name:BATTY
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 1:3787 DOCTORS DR
Mailing Address - Street 2:SUITE 212
Mailing Address - City:PORT ARTHUR
Mailing Address - State:TX
Mailing Address - Zip Code:77642-5514
Mailing Address - Country:US
Mailing Address - Phone:409-985-3676
Mailing Address - Fax:
Practice Address - Street 1:3787 DOCTORS DR
Practice Address - Street 2:SUITE 212
Practice Address - City:PORT ARTHUR
Practice Address - State:TX
Practice Address - Zip Code:77642-5514
Practice Address - Country:US
Practice Address - Phone:409-985-3676
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1369207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C468Medicare ID - Type Unspecified
C13263Medicare UPIN