Provider Demographics
NPI:1023250420
Name:GEORGE, CAROLE L (MSN, BC-ACNS, CDE)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:L
Last Name:GEORGE
Suffix:
Gender:F
Credentials:MSN, BC-ACNS, CDE
Other - Prefix:
Other - First Name:CAROLE
Other - Middle Name:
Other - Last Name:LAMZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6500 N MO PAC EXPY
Mailing Address - Street 2:BLDG. 3, SUITE 200
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-3282
Mailing Address - Country:US
Mailing Address - Phone:512-458-8400
Mailing Address - Fax:512-458-8593
Practice Address - Street 1:6500 N MO PAC EXPY
Practice Address - Street 2:BLDG. 3, SUITE 200
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-3282
Practice Address - Country:US
Practice Address - Phone:512-458-8400
Practice Address - Fax:512-458-8593
Is Sole Proprietor?:No
Enumeration Date:2009-03-31
Last Update Date:2011-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX648547364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8L11916Medicare PIN
TXTXB123876Medicare PIN