Provider Demographics
NPI:1962675173
Name:CAREY, ANGELA A (MA, CCC-A)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:A
Last Name:CAREY
Suffix:
Gender:F
Credentials:MA, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9024 BALCONES CLUB DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78750-2906
Mailing Address - Country:US
Mailing Address - Phone:512-382-5218
Mailing Address - Fax:
Practice Address - Street 1:9024 BALCONES CLUB DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2906
Practice Address - Country:US
Practice Address - Phone:512-382-5218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
231H00000X
TX51730237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX196015501Medicaid
TX196015503Medicaid
TX196015504Medicaid
TX196015502Medicaid
TX196015504Medicaid
TX196015501Medicaid
TX196015503Medicaid
TX8L26230Medicare PIN
TX8L4306Medicare PIN