Provider Demographics
NPI:1952345217
Name:CARR, KAREN M (DO)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:M
Last Name:CARR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 911230
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75391-1230
Mailing Address - Country:US
Mailing Address - Phone:972-997-9000
Mailing Address - Fax:972-437-9605
Practice Address - Street 1:301 NORTH N STREET
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79701
Practice Address - Country:US
Practice Address - Phone:432-685-1559
Practice Address - Fax:432-683-6973
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2008-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK2429207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000S8863Medicaid
TX8R1404OtherBLUE CROSS OF TEXAS
TX8D9751Medicare PIN
NM000S8863Medicaid
TX81Z786Medicare PIN
TX86Y605Medicare PIN