Provider Demographics
NPI:1669205654
Name:BARNES, CARIE MARIE (OT)
Entity type:Individual
Prefix:
First Name:CARIE
Middle Name:MARIE
Last Name:BARNES
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:CARIE
Other - Middle Name:MARIE
Other - Last Name:LOUDENSLAGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2011 BROADWAY ST STE 130
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5945
Mailing Address - Country:US
Mailing Address - Phone:512-431-4721
Mailing Address - Fax:
Practice Address - Street 1:3901 S LAMAR BLVD STE 160
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-7990
Practice Address - Country:US
Practice Address - Phone:512-431-4721
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-23
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX116013225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist