Provider Demographics
NPI:1710962774
Name:BOBICK, CARRIE (PA)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:BOBICK
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:13376 RESEARCH BLVD
Mailing Address - Street 2:STE 110
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-2257
Mailing Address - Country:US
Mailing Address - Phone:737-346-3499
Mailing Address - Fax:737-346-3501
Practice Address - Street 1:3708 JEFFERSON ST STE A
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-6206
Practice Address - Country:US
Practice Address - Phone:512-459-6503
Practice Address - Fax:512-454-7453
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2019-02-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXPA04522363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
437452YMVUOtherWELLMED NETWORKS INC
TX8D9708Medicare PIN
TXQ52064Medicare UPIN