1063195741 NPI number — MRS. CAROL CHRISTINA MYERS DPT

Table of content: MRS. CAROL CHRISTINA MYERS DPT (NPI 1063195741)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063195741 NPI number — MRS. CAROL CHRISTINA MYERS DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MYERS
Provider First Name:
CAROL
Provider Middle Name:
CHRISTINA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COX
Provider Other First Name:
CAROL
Provider Other Middle Name:
CHRISTINA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1063195741
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/01/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20635 MORNING CREEK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KATY
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77450-6699
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-562-7789
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8323 SOUTHWEST FWY
Provider Second Line Business Practice Location Address:
#101
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77074-1636
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-772-1400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/09/2023

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: 2251P0200X , with the licence number:  1379471 , 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)





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