1417229360 NPI number — JANIDA LANET CARTER PHD

Table of content: JANIDA LANET CARTER PHD (NPI 1417229360)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417229360 NPI number — JANIDA LANET CARTER PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARTER
Provider First Name:
JANIDA
Provider Middle Name:
LANET
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RICE
Provider Other First Name:
JANIDA
Provider Other Middle Name:
LANET
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1417229360
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/13/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5100 ELDORADO PKWY
Provider Second Line Business Mailing Address:
SUITE 102-343
Provider Business Mailing Address City Name:
MCKINNEY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
903-327-3370
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 ELDORADO PKWY
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
MCKINNEY
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75070-4367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
903-327-3370
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/07/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  31442 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)