Provider Demographics
NPI:1629784012
Name:MCCARTER, LENISE LYN (PT)
Entity Type:Individual
Prefix:
First Name:LENISE
Middle Name:LYN
Last Name:MCCARTER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13209 FM 2796
Mailing Address - Street 2:
Mailing Address - City:PITTSBURG
Mailing Address - State:TX
Mailing Address - Zip Code:75686-8224
Mailing Address - Country:US
Mailing Address - Phone:903-505-9509
Mailing Address - Fax:
Practice Address - Street 1:13209 FM 2796
Practice Address - Street 2:
Practice Address - City:PITTSBURG
Practice Address - State:TX
Practice Address - Zip Code:75686-8224
Practice Address - Country:US
Practice Address - Phone:903-505-9509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1116408208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation