Provider Demographics
NPI:1821832387
Name:MOGEN, CAROL SUE
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:SUE
Last Name:MOGEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 QUAIL RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-4259
Mailing Address - Country:US
Mailing Address - Phone:512-663-0438
Mailing Address - Fax:
Practice Address - Street 1:1110 QUAIL RIDGE DR
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-4259
Practice Address - Country:US
Practice Address - Phone:512-663-0438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-20
Last Update Date:2024-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No172M00000XOther Service ProvidersMechanotherapist