1487655932 NPI number — MICHAEL LINDSEY CARROLL MD

Table of content: MICHAEL LINDSEY CARROLL MD (NPI 1487655932)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487655932 NPI number — MICHAEL LINDSEY CARROLL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARROLL
Provider First Name:
MICHAEL
Provider Middle Name:
LINDSEY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARROLL
Provider Other First Name:
MICHAEL
Provider Other Middle Name:
LINDSEY
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1487655932
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 870220
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MESQUITE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75187-0220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
214-398-3251
Provider Business Mailing Address Fax Number:
214-398-7251

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
929 N GALLOWAY AVE STE 210
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MESQUITE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75149-2491
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
214-398-3251
Provider Business Practice Location Address Fax Number:
214-398-7251
Provider Enumeration Date:
08/09/2005

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: 207R00000X , with the licence number:  F3813 , 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)

  • Identifier: 099398202 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".




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