Provider Demographics
NPI:1760260350
Name:BYERS, CARRIE (IBCLC, RLC)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:BYERS
Suffix:
Gender:F
Credentials:IBCLC, RLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:304 CORONADO DR
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:TX
Mailing Address - Zip Code:76431-1946
Mailing Address - Country:US
Mailing Address - Phone:817-946-8055
Mailing Address - Fax:
Practice Address - Street 1:304 CORONADO DR
Practice Address - Street 2:
Practice Address - City:CHICO
Practice Address - State:TX
Practice Address - Zip Code:76431-1946
Practice Address - Country:US
Practice Address - Phone:817-946-8055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-15
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXL-12066174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN