Provider Demographics
NPI:1639603590
Name:CARLETON, DOROTHY CLARE (NP-C)
Entity Type:Individual
Prefix:
First Name:DOROTHY
Middle Name:CLARE
Last Name:CARLETON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 S WILLIAM BARNETT AVE
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:TX
Mailing Address - Zip Code:77327-4962
Mailing Address - Country:US
Mailing Address - Phone:281-592-5000
Mailing Address - Fax:
Practice Address - Street 1:117 S WILLIAM BARNETT AVE
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327-4962
Practice Address - Country:US
Practice Address - Phone:281-592-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133594363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily