Provider Demographics
NPI:1356515480
Name:CARTER, ANGELA NIX (MS,CCC-SLP)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:NIX
Last Name:CARTER
Suffix:
Gender:F
Credentials:MS,CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 LONDONDERRY DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76712-7924
Mailing Address - Country:US
Mailing Address - Phone:254-776-7744
Mailing Address - Fax:
Practice Address - Street 1:3115 PINE AVE
Practice Address - Street 2:808
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76708-3247
Practice Address - Country:US
Practice Address - Phone:254-753-0351
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-18
Last Update Date:2008-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10923235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist