Provider Demographics
NPI:1811993678
Name:CARSON, BARBARA (FNP)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:CARSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7201 MANCHACA RD
Mailing Address - Street 2:STE B
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78745-5259
Mailing Address - Country:US
Mailing Address - Phone:512-443-3577
Mailing Address - Fax:512-445-6027
Practice Address - Street 1:7201 MANCHACA RD
Practice Address - Street 2:STE B
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-5259
Practice Address - Country:US
Practice Address - Phone:512-443-3577
Practice Address - Fax:512-445-6027
Is Sole Proprietor?:No
Enumeration Date:2005-06-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX588648363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXS83917Medicare UPIN
TX82N991Medicare ID - Type Unspecified