Provider Demographics
NPI:1801896295
Name:CARPENTER, ROBERT J JR (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:J
Last Name:CARPENTER
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6624 FANNIN ST
Mailing Address - Street 2:SUITE 2720
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2312
Mailing Address - Country:US
Mailing Address - Phone:713-795-4600
Mailing Address - Fax:713-795-4422
Practice Address - Street 1:6624 FANNIN ST
Practice Address - Street 2:SUITE 2720
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2312
Practice Address - Country:US
Practice Address - Phone:713-795-4600
Practice Address - Fax:713-795-4422
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-28
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXE0847174400000X, 207V00000X, 207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No174400000XOther Service ProvidersSpecialist
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX000000AC48OtherBLUE CROSS/BLUE SHIELD
TX122539302Medicaid
TX122539302Medicaid
TX00AC48Medicare PIN
TX000000AC48OtherBLUE CROSS/BLUE SHIELD
TX8J7345Medicare PIN