Provider Demographics
NPI:1336544709
Name:CARNES, DARREN
Entity Type:Individual
Prefix:MR
First Name:DARREN
Middle Name:
Last Name:CARNES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 305
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:TX
Mailing Address - Zip Code:75758-0305
Mailing Address - Country:US
Mailing Address - Phone:903-360-7475
Mailing Address - Fax:903-849-0225
Practice Address - Street 1:321 CRESTVIEW ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:TX
Practice Address - Zip Code:75758-2343
Practice Address - Country:US
Practice Address - Phone:903-360-7475
Practice Address - Fax:903-849-0225
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX171WH0202XOtherNPPES