Provider Demographics
NPI:1013109875
Name:CARSON, ELIZABETH ANN (M S)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:CARSON
Suffix:
Gender:F
Credentials:M S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:611 W STATE HIGHWAY 6 STE 113
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-7545
Mailing Address - Country:US
Mailing Address - Phone:254-878-4040
Mailing Address - Fax:469-673-2866
Practice Address - Street 1:611 W STATE HIGHWAY 6 STE 113
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-7545
Practice Address - Country:US
Practice Address - Phone:254-878-4040
Practice Address - Fax:469-673-2866
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX50989237600000X, 231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter