Provider Demographics
NPI:1750438545
Name:CARPENTER, ROBERT OWENS (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:OWENS
Last Name:CARPENTER
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8441 STATE HIGHWAY 47 STE 3115
Mailing Address - Street 2:
Mailing Address - City:BRYAN
Mailing Address - State:TX
Mailing Address - Zip Code:77807-3207
Mailing Address - Country:US
Mailing Address - Phone:979-436-0483
Mailing Address - Fax:979-436-0072
Practice Address - Street 1:2900 E 29TH ST
Practice Address - Street 2:
Practice Address - City:BRYAN
Practice Address - State:TX
Practice Address - Zip Code:77802-2622
Practice Address - Country:US
Practice Address - Phone:979-776-8440
Practice Address - Fax:877-601-5854
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2021-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN38885208600000X
TXN3538208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3001577OtherTN MEDICARE PROVIDER NUMBER