Provider Demographics
NPI:1629574355
Name:ABEYTA, CARRIE M (COTA)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:M
Last Name:ABEYTA
Suffix:
Gender:F
Credentials:COTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5604 DAVIS BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTH RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:75022
Mailing Address - Country:US
Mailing Address - Phone:817-581-0111
Mailing Address - Fax:
Practice Address - Street 1:5604 DAVIS BLVD
Practice Address - Street 2:
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:75022
Practice Address - Country:US
Practice Address - Phone:817-581-0111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-02
Last Update Date:2018-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health