Provider Demographics
NPI:1851863724
Name:CARTER, GINA
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:WAFER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1400 W PHILLIPS ST
Mailing Address - Street 2:
Mailing Address - City:ALVIN
Mailing Address - State:TX
Mailing Address - Zip Code:77511-5933
Mailing Address - Country:US
Mailing Address - Phone:409-256-4282
Mailing Address - Fax:
Practice Address - Street 1:210 S. HWY 3
Practice Address - Street 2:UNIT B
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573
Practice Address - Country:US
Practice Address - Phone:832-509-5059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-17
Last Update Date:2018-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies