Provider Demographics
NPI:1629311352
Name:BAKUNAS, CARRIE ALETTA (MD)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:ALETTA
Last Name:BAKUNAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:CARRIE
Other - Middle Name:ALETTA
Other - Last Name:KESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6431 FANNIN ST
Mailing Address - Street 2:4TH FLOOR JJL
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-1501
Mailing Address - Country:US
Mailing Address - Phone:713-500-7878
Mailing Address - Fax:713-500-0758
Practice Address - Street 1:6431 FANNIN ST
Practice Address - Street 2:4TH FLOOR JJL
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-1501
Practice Address - Country:US
Practice Address - Phone:713-500-7878
Practice Address - Fax:713-500-0758
Is Sole Proprietor?:No
Enumeration Date:2013-04-01
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TXQ4023207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program