Provider Demographics
NPI:1669490215
Name:FIFE, CAROLINE E (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:E
Last Name:FIFE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:2700 RESEARCH FOREST DR
Mailing Address - Street 2:STE. 100
Mailing Address - City:THE WOODLANDS
Mailing Address - State:TX
Mailing Address - Zip Code:77381-4252
Mailing Address - Country:US
Mailing Address - Phone:800-603-7896
Mailing Address - Fax:832-550-2941
Practice Address - Street 1:17450 ST LUKES WAY
Practice Address - Street 2:STE 350
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77384-8044
Practice Address - Country:US
Practice Address - Phone:936-266-2150
Practice Address - Fax:936-266-8527
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2016-07-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXG8104207Q00000X, 207RC0000X, 2083P0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX125858404Medicaid
TX88Y442OtherBCBS
TXB22697Medicare UPIN
TX080123911Medicare PIN
TX125858404Medicaid