Provider Demographics
NPI:1932155942
Name:COLE, CARLA JEAN (DO)
Entity Type:Individual
Prefix:DR
First Name:CARLA
Middle Name:JEAN
Last Name:COLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Middle Name:
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Mailing Address - Street 1:323 N SHILOH RD
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-6610
Mailing Address - Country:US
Mailing Address - Phone:972-272-2777
Mailing Address - Fax:972-276-0932
Practice Address - Street 1:323 N SHILOH RD
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-6610
Practice Address - Country:US
Practice Address - Phone:972-272-2777
Practice Address - Fax:972-276-0932
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2022-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK7265208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXH00118Medicare UPIN