Provider Demographics
NPI:1972829349
Name:CARR, CHRISTOPHER W (MD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:W
Last Name:CARR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5924 ROYAL LN
Mailing Address - Street 2:SUITE 104
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75230-3863
Mailing Address - Country:US
Mailing Address - Phone:214-987-3376
Mailing Address - Fax:
Practice Address - Street 1:5924 ROYAL LN
Practice Address - Street 2:SUITE 104
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-3863
Practice Address - Country:US
Practice Address - Phone:214-987-3376
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-10
Last Update Date:2014-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ0227207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology